Headache after head injury is of concern if it’s of long term. Generally headaches go away after a few minutes or days if its a small accidental injury. But the persisting headaches are called post-traumatic or post-concussion headaches.
Normally soldiers returning from Afghanistan and Iraq have these troubles as they are more prone to such head injuries. Though a finite number of studies have been done on them to relate long term effects, it’s still unclear what the treatment has to be.
In a study, it is found that 30% of patients report long term headaches after injury. Headache is also one of the common symptom after traumatic brain injury (shortly called TBI).
Cause of Headaches after Brain Injury
Just after a severe TBI, patients have headaches because of the surgery on their skulls. Also there may be a small collection of blood or fluid inside the skull.
These generally occur after a mild to moderate injury or just after the initial healing phase is over. The reasons for such headaches can be due to myriad of reasons like change in the brain caused by the injury, neck and skull injuries that have not fully healed, tension and stress or side effects due to medication.
Typical Kinds of Long Term HeadAches after TBI
Migraine headaches, Tension-type headaches, cervicogenic headaches, rebound headaches are some of the common types. Migraine headaches have typical symptoms like dull, throbbing sensation, usually on one side of the head, nausea or vomiting, light and sound sensitivity, pain level from moderate to severe, seeing aura etc.
In a study conducted by the Journal of Neurotrauma, a sample survey was conducted to describe the natural history of headache after TBI. The trial was conducted on an age group of 452 acute, consecutive patienets admitted to inpatient rehabilitation with TBI.
The results showed that 71% of participants reported headache during the first year after injury. Persons with a pre-injury history of headache (p<0.001) and females (p<0.01) were significantly more likely to report headache.
The conclusion of the study was that a better understanding of the natural history of headache including timing, type, and risk factors should help in the design of treatment studies to reduce the severity of the headache.
Treatment for Long Term Headache After TBI
The treatment for any type of headache depends on the diagnosis. If it’s a tension-type headache, they are easily treated with over the counter medications like
- Ibuprofen (Advil, Motrin IB, others)
- Acetaminophen (Tylenol, others)
There are also some alternative therapies like meditation, relaxation training, cognitive behavioral therapy, biofeedback, massage etc.
If it’s a migraine headache, the treatment is aimed at relieving symptoms and preventing additional attacks. Avoiding triggers for migraines (if you know them) also helps. Other remedies like prescription medications, rest in a quiet, dark room, hot or cold compresses to your head or neck, massage and small amounts of caffeine also helps.
If it’s a cluster headache, and recur for weeks at a time these are rare type. The treatment lies in preventive medications, Injectable medications, such as sumatriptan (Imitrex, Sumavel Dosepro, others), for quick relief during an attack, Prescription triptan nasal sprays, such as zolmitriptan (Zomig) or sumatriptan (Imitrex), Inhalation of 100 percent oxygen through a mask. Pacing, rocking or head rubbing because most people feel restless during a cluster headache.
If it’s a chronic headache and occurs almost every day, then the treatment for any underlying diseases or conditions stops that kind of headache. If no underlying disease is found, then the treatment is focused on preventive medication.