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Post-Traumatic Headache

Definition

A post-traumatic headache is a common symptom following injury or trauma to the head and neck.
Head and Neck
IMAGE
Copyright © Nucleus Medical Media, Inc.

Causes

Post-traumatic headache occurs after a trauma to the head and neck. The headache may be caused by:
  • Blood or fluid buildup inside the skull
  • Changes in the brain caused by the injury
  • Neck and skull injuries that are still healing
  • Tension and stress
There are different types of headaches. Common post-traumatic headache types include:
  • Tension headaches due to muscle tension or spasms and stress
  • Migraine headaches due to a sensitive area in the brain that triggers a pain signal
  • Cervicogenic headaches due to injury to the muscles and soft tissues
  • Rebound headaches from medications used to treat headaches
The headache may also include psychiatric, behavioral, or social factors.

Risk Factors

Your chance of a getting a post-traumatic headache is increased if you have had a history of head injuries.

Symptoms

A post-traumatic headache may occur right after the injury or as the injury is healing. Symptoms may include:
  • Head pain—symptoms depend on the cause of the headache
  • Nausea or vomiting
  • Light and sound sensitivity
  • Visual problems such as seeing spots or bright lights
  • Pain that occurs at the end of the day
  • Pain that starts in the neck, shoulders, and back of the head
  • Pain with neck movement
  • Lightheadedness
  • Difficulty sleeping
  • Problems concentrating
  • Mood and personality changes

Diagnosis

You will be asked about your symptoms, medical history, and any recent injuries. A physical exam will be done. The diagnosis is based on the exam and history. You may be referred to a doctor who specializes in the brain and nervous system if the headache persists, there are changes on the exam, or it is severe.
You will also be asked about the frequency and pattern of your headaches. To help provide answers, you may consider keeping a diary of:
  • When your headaches start and end
  • What you were doing at the time
  • What you tried to relieve the pain
  • Any other symptoms you had with your headache
Images may be taken of your brain, head, and neck to look for signs of injury. This can be done with:

Treatment

Talk with your doctor about the best treatment plan for you. Options include:

Medications

Your doctor may advise medications to help manage pain. Medication options may include:
  • Non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen
  • Over-the-counter medications for migraines
  • Prescription pain medication
  • Muscle relaxants
  • Anti-anxiety medication—rarely

Rest

Head and neck injuries can take some time to heal. It is important to follow your doctor’s advice and adjust activities as needed. Complete rest is rarely needed.
Other home care steps may include ice and massage.
Stress-reduction techniques and stress-management techniques may also help decrease or manage pain.

Prevention

To help reduce your chance of getting a head and neck injury, take these steps:
  • Wear a helmet during certain activities (such as riding a bike or motorcycle, playing a contact sport, using skates, scooters, or skateboards, riding a horse, skiing or snowboarding).
  • Reduce falling hazards at home.
  • Always wear a seat belt in motor vehicles.
  • Never drink and drive.
  • Avoid using sedatives, especially when driving.

RESOURCES

American Academy of Family Physicians http://www.aafp.org

The National Headache Foundation http://www.headaches.org

CANADIAN RESOURCES

Canadian Association of Emergency Physicians http://caep.ca

Health Canada http://www.hc-sc.gc.ca

References

Finkel A. Concussion and post-traumatic headache. American Headache Association website. Available at: http://www.americanheadachesociety.org/assets/1/7/Alan%5FFinkel%5F-%5FConcussion%5Fand%5FPTH.pdf. Accessed January 9, 2014.

Headache. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 22, 2013. Accessed January 9, 2014.

Headaches after head injuries—post-traumatic headaches. Brainline.org website. Available at: http://www.brainline.org/content/2008/12/headaches-after-head-injuries-8212-post-traumatic-headaches.html. Accessed January 9, 2014.

Headaches after traumatic brain injury. Model Systems Knowledge Translation Center website. Available at: http://www.msktc.org/tbi/factsheets/Headaches-After-Traumatic-Brain-Injury. Accessed January 9, 2014.

Lane JC, Arciniegas DB. Post-traumatic headache. Curr Treat Options Neurol. 2002 Jan;4(1):89-104.

Lenaerts ME, Couch JR. Posttraumatic headache. Curr Treat Options Neurol. 2004;6:507-517.

Marcus DA. Disability and chronic post-traumatic headache. Headache: Journal of Head & Face Pain. 2003;43:117-121.

Post-traumatic headache. National Headache Foundation website. Available at: http://www.headaches.org/education/Headache%5FTopic%5FSheets/Post%5FTraumatic%5FHeadache. Accessed January 9, 2014.

Sheedy J, Harvey E, et al. Emergency department assessment of mild traumatic brain injury and the prediction of post-concussive symptoms in a 3-month prospective study. J Head Trauma Rehabil. 2009;24(5):333-343.

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