Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentPrognosisCoping
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Coping
Post-traumatic headache (PTH) is defined as the onset of persistent headaches within seven days of experiencing altered consciousness due to a blow or impact to the head. PTH is the most frequently reported complaint following atraumatic brain injury(TBI). The symptoms of PTH vary widely, though most people experience eithermigraineortension headachetype symptoms.
This condition is potentially disabling—especially when chronic. Treatment often consists of a combination of at-home approaches, medications, and other approaches.Here’s a quick overview of post-traumatic headache, including its causes, how it’s diagnosed, and treatment and management options.
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Post-Traumatic Headache Symptoms
The symptoms of PTH generally arise within seven days of a traumatic brain injury (TBI), which is a significant injury to the head that often leads to a loss of consciousness.
Though this condition can take many forms, most people experience symptoms similar to either migraines or tension headaches. These are two types ofprimary headache disorders, headaches that arise in absence of other medical conditions.
When resembling tension headache, the symptoms include:
PTH that resembles migraine causes:
Additional symptoms of traumatic brain injury coexisting with PTH can include:
Acute vs. Chronic PTHA case of PTH is considered chronic if symptoms persist and/or recur for over three months. Cases that resolve within this time are considered acute.
Acute vs. Chronic PTH
A case of PTH is considered chronic if symptoms persist and/or recur for over three months. Cases that resolve within this time are considered acute.
Most post-traumatic headaches are the direct result of traumatic brain injuries. These can range in severity frommild TBIs (concussions)to much more severe cases. Brain injuries can occur when the tissues of the brain strike the sides of the skull due to an impact or whiplash, for example. The most common causes of TBIs are:
The Most Common Types of Traumatic Brain Injury
Currently, researchers don’t have a complete understanding of the physiology of post-traumatic headaches. As to the mechanism of PTH, evidence from neuroimaging and other kinds of studies suggest several potential explanations:
A diagnosis of post-traumatic headache is considered when headaches start within seven days of a TBI. However, since there are many headache disorders—and since PTH can present in many different ways—it’s essential for healthcare providers to investigate the causes of the symptoms. Typically, this includes:
Brain Imaging Tests
Treating Post-Traumatic Headache
There’s no set therapy for PTH, and the condition tends to be treated based on how it presents. Migraine-like PTH is treated as migraines, and tension headache PTH is treated as headaches would be treated for that condition. Since individual cases vary so much, treatment and management plans need to be customized, mixing and matching strategies to manage the issue.
Acute Medications
There are two types of medications for headache disorders: acute and preventive. Acute medications manage pain and other symptoms after PTH has set on. Several classes of acute drugs are recommended over the counter (OTC) or prescribed, though overuse may lead to problems:
Preventive Medications
In chronic post-traumatic headache cases—in which the headaches return and recur even after two months—medications may also be prescribed to prevent them. Classes of these drugs usually prescribed for migraines include:
Counseling and Therapy
Several therapeutic methods have been shown to be effective in taking on chronic pain problems, such as chronic PTH. Common among these approaches iscognitive behavioral therapy (CBT), which works to increase the patient’s conscious control of pain responses.A mental health professional can help you with strategies for easing tension, relaxation, and coping with pain.
Chronic headache sufferers are also prone to mental health challenges, such as anxiety and depression. Counseling can prove critical in taking on these issues.
Choosing the Right Therapist
Biofeedback and Relaxation Training
Another approach to chronic headaches, such as persistent PTH, is the use of biofeedback and relaxation techniques. Basically, a wearable device will track physiological signs of stress—such as muscle tension and body temperature—which can set off attacks or worsen pain. With that information, users can begin to sense issues arising and work to prevent them.
Patients can learn relaxation strategies, such as breathing exercises, through these techniques. This has been shown to reduce the frequency and intensity of headaches.
Lifestyle Modifications
Alongside pharmaceutical management, making certain lifestyle changes can make a big difference when it comes to chronic PTH. Frequently recommended strategies include:
Headache DiariesIf you have chronic PTH, it’s a good idea to keep track of your headaches, especially if you experience migraine symptoms. This means logging when PTH attacks are happening, how long they last, what medications you’re taking, your meals and sleep, as well as any foods or drinks that are acting as triggers.
Headache Diaries
If you have chronic PTH, it’s a good idea to keep track of your headaches, especially if you experience migraine symptoms. This means logging when PTH attacks are happening, how long they last, what medications you’re taking, your meals and sleep, as well as any foods or drinks that are acting as triggers.
Other Approaches
Very difficult to manage (refractory) cases, of chronic headache may also be treated with a range of other medical approaches, including:
Post-traumatic headache is very common among those who experience TBI. However, in cases of concussion or mild TBI, the vast majority of cases resolve within days to weeks.
While many cases resolve within three months, chronic cases prove particularly challenging. As with other headache disorders, prolonged PTH can cause or worsen depression and anxiety, and affect sleep quality.Sleep problems can, in turn, make headache problems even worse.
The Link Between Mental Health and Your Headaches
Coping With Post-Traumatic Headache
There’s no doubt that headache disorders can be difficult to live with, especially in more severe cases. This is why psychiatric evaluation and therapy are often important aspects of treatment for PTH. But what else can you do to cope with this difficult condition? According to the American Psychological Association (APA), there are several steps you can take, including:
Summary
Post-traumatic headache (PTH) is frequently defined as a headache arising within seven days of a traumatic brain injury. Its presentation can vary, with some experiencing milder, tension headache symptoms, while others have symptoms like those of migraines or rare headache syndromes.
Treatments for this condition involve everything from medications to lifestyle adjustments to biofeedback and relaxation techniques. More difficult cases may require transcranial stimulation or decompression surgery.
If headache characteristically worsens with activity, it is important to take note your capacity for activity and gradually make adjustments. This is often done with guidance from a neurologist and/or physical therapist.
Although PTH after mild TBI usually resolves within weeks, chronic PTH can be very challenging, and, especially when persistent, may significantly impact mental health and morale. Stress management, finding support from family, friends, and fellow chronic pain sufferers, or counseling can all help you cope.
A Word From Verywell
Among the many impacts of traumatic brain injury, post-traumatic headache is the most common, and it can be very debilitating. It’s hard to live with unpredictable pain. But while there’s more that doctors need to learn about this condition, the good news is that our understanding of PTH is continuing to grow.
New therapies will be added to the extensive list of approaches to this disorder, making outcomes even better for sufferers. It helps to stay informed about your condition, work on strategies to manage it, and not hold back in asking for help when you need it.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lagman-Bartolome AM.Post-traumatic headache. American Migraine Foundation.Baker V, Eliasen K, Hack N.Lifestyle modifications as therapy for medication refractory post-traumatic headache (PTHA) in the military population of Okinawa.J Headache Pain. 2018;19(1). doi:10.1186/s10194-018-0943-2National Institutes of Health.Traumatic brain injury (TBI). MedlinePlus.Labastida-Ramírez A, Benemei S, Albanese M et al.Persistent post-traumatic headache: a migrainous loop or not? The clinical evidence.J Headache Pain. 2020;21(1). doi:10.1186/s10194-020-01122-5Defrin R.Chronic post-traumatic headache: clinical findings and possible mechanisms.J Man Manip Ther. 2013;22(1):36-43. doi:10.1179/2042618613y.0000000053Finkel A.Information for health care professionals: concussion and post-traumatic headache. American Headache Society.Larsen E, Ashina H, Iljazi A et al.Acute and preventive pharmacological treatment of post-traumatic headache: a systematic review.J Headache Pain. 2019;20(1). doi:10.1186/s10194-019-1051-7Lipchick G.Biofeedback & relaxation training for headache. American Migraine Foundation.American Migraine Foundation.Headache hygiene: What is it?.American Psychological Association.Coping with chronic pain.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lagman-Bartolome AM.Post-traumatic headache. American Migraine Foundation.Baker V, Eliasen K, Hack N.Lifestyle modifications as therapy for medication refractory post-traumatic headache (PTHA) in the military population of Okinawa.J Headache Pain. 2018;19(1). doi:10.1186/s10194-018-0943-2National Institutes of Health.Traumatic brain injury (TBI). MedlinePlus.Labastida-Ramírez A, Benemei S, Albanese M et al.Persistent post-traumatic headache: a migrainous loop or not? The clinical evidence.J Headache Pain. 2020;21(1). doi:10.1186/s10194-020-01122-5Defrin R.Chronic post-traumatic headache: clinical findings and possible mechanisms.J Man Manip Ther. 2013;22(1):36-43. doi:10.1179/2042618613y.0000000053Finkel A.Information for health care professionals: concussion and post-traumatic headache. American Headache Society.Larsen E, Ashina H, Iljazi A et al.Acute and preventive pharmacological treatment of post-traumatic headache: a systematic review.J Headache Pain. 2019;20(1). doi:10.1186/s10194-019-1051-7Lipchick G.Biofeedback & relaxation training for headache. American Migraine Foundation.American Migraine Foundation.Headache hygiene: What is it?.American Psychological Association.Coping with chronic pain.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Lagman-Bartolome AM.Post-traumatic headache. American Migraine Foundation.Baker V, Eliasen K, Hack N.Lifestyle modifications as therapy for medication refractory post-traumatic headache (PTHA) in the military population of Okinawa.J Headache Pain. 2018;19(1). doi:10.1186/s10194-018-0943-2National Institutes of Health.Traumatic brain injury (TBI). MedlinePlus.Labastida-Ramírez A, Benemei S, Albanese M et al.Persistent post-traumatic headache: a migrainous loop or not? The clinical evidence.J Headache Pain. 2020;21(1). doi:10.1186/s10194-020-01122-5Defrin R.Chronic post-traumatic headache: clinical findings and possible mechanisms.J Man Manip Ther. 2013;22(1):36-43. doi:10.1179/2042618613y.0000000053Finkel A.Information for health care professionals: concussion and post-traumatic headache. American Headache Society.Larsen E, Ashina H, Iljazi A et al.Acute and preventive pharmacological treatment of post-traumatic headache: a systematic review.J Headache Pain. 2019;20(1). doi:10.1186/s10194-019-1051-7Lipchick G.Biofeedback & relaxation training for headache. American Migraine Foundation.American Migraine Foundation.Headache hygiene: What is it?.American Psychological Association.Coping with chronic pain.
Lagman-Bartolome AM.Post-traumatic headache. American Migraine Foundation.
Baker V, Eliasen K, Hack N.Lifestyle modifications as therapy for medication refractory post-traumatic headache (PTHA) in the military population of Okinawa.J Headache Pain. 2018;19(1). doi:10.1186/s10194-018-0943-2
National Institutes of Health.Traumatic brain injury (TBI). MedlinePlus.
Labastida-Ramírez A, Benemei S, Albanese M et al.Persistent post-traumatic headache: a migrainous loop or not? The clinical evidence.J Headache Pain. 2020;21(1). doi:10.1186/s10194-020-01122-5
Defrin R.Chronic post-traumatic headache: clinical findings and possible mechanisms.J Man Manip Ther. 2013;22(1):36-43. doi:10.1179/2042618613y.0000000053
Finkel A.Information for health care professionals: concussion and post-traumatic headache. American Headache Society.
Larsen E, Ashina H, Iljazi A et al.Acute and preventive pharmacological treatment of post-traumatic headache: a systematic review.J Headache Pain. 2019;20(1). doi:10.1186/s10194-019-1051-7
Lipchick G.Biofeedback & relaxation training for headache. American Migraine Foundation.
American Migraine Foundation.Headache hygiene: What is it?.
American Psychological Association.Coping with chronic pain.
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