Post-concussion, or post-traumatic, headaches are one of the most common symptoms of a concussion. Many patients report that this type of headache is distinctly different from a normal one, likely because its causes and presentations are different. Post-concussion headaches often go away within a few days after the injury, although they can persist for months in some cases.
A concussion is a mild form of a traumatic brain injury. Traumatic brain injuries can be caused by a direct blow to the head by an object or violent shaking of the head. Victims often aren’t aware of what has happened to them, so it’s important for those around them to watch for these signs after a fall or blow to the head. Anyone who receives a head injury should stop any physical activity immediately until receiving an evaluation by a medical professional, especially if the injury occurred during a full-contact sport. If this assessment indicates a concussion, the injured person should cease physical activity for that day, no matter how mild the symptoms are.
In addition to a headache, the immediate symptoms of a concussion often include the following:
- Cognitive difficulties
- Double vision
- Loss of consciousness
- Slurred speech
More serious symptoms may also occur including vomiting, continued confusion, worsening of speech. The most serious symptoms include bleeding into the brain, swelling of the brain and prolonged loss of consciousness, but these are very rare for a simple concussion and are more typical of moderate or severe traumatic brain injuries. These symptoms require additional evaluation by a medical professional to determine the severity.
After addressing critical injuries requiring immediate care, headaches are one of the most significant symptom of a concussion. Sensory stimuli like light or noise can trigger these headaches, causing secondary symptoms like irritability and nausea. Contact your medical provider for additional evaluation and management if these symptoms last for more than a week, or if they get worse over time.
Rest is the most important therapy for the first few days after receiving a concussion. This restriction should include any significant physical exercise and activities that require looking at a monitor. In addition, you should only engage in limited school or office work until symptoms improve. Once that happens, you can gradually increase activity as recommended by your physician. Return to a lower activity level if the symptoms return or get worse.
Post-concussion headaches can take many forms, but usually resemble tension headaches or migraines. For these types of post-concussion headaches, acetaminophen (Tylenol) is a standard medical treatment. Ibuprofen (Advil) and naproxen (Aleve) are also commonly used, especially for more severe headaches or when acetaminophen is contraindicated. When the headaches specifically resemble migraine (for example, they are associated with light and noise sensitivity), care providers may also consider stronger medication like sumatriptan (Imitrex) for very severe migraine headaches. Resting in a dark, quiet place with a cold pack is often helpful as well.
Additional therapies for post-concussion headaches include the following:
- Plenty of water
- Regular sleep
- Regular meals
- Stress management
Post-concussion headaches that last for longer than a week may require management under a long-term plan that focuses on maintaining a regular routine for eating, sleeping, hydration, and stress management. It should also include medications to treat existing headaches and medications that reduce the likelihood of headaches developing in the future. Treatments often depend on the form of post-concussion headaches: for example, standard preventive treatments for migraine may help people with post-concussion headaches that resemble migraine.
A medical provider may add low-impact aerobic exercise to your treatment plan if the headaches last longer than a few weeks, since long periods with no exercise at all may make the headaches worse. These activities include slow walking, biking, and swimming that don’t increase your heart rate to your aerobic threshold. Multiple concussions are a cause for concern, as their effects can be cumulative. This issue should prompt serious consideration about the benefits and risks of engaging in the sport or other activity causing the concussions.
About The Will Erwin Headache Research Foundation
The Will Erwin Headache Research Foundation is dedicated to furthering research on headaches and finding a cure for the pain they cause to millions of sufferers throughout the world. We’re also working diligently to promote awareness of the treatment options currently available. Please consider contributing to The Foundation today.