Post-traumatic headache is a headache which occurs after any injury or trauma to the head or neck. Majority of the people tend to experience headache even after a mild head injury. The headache can occur immediately after the injury or it can start about a week after the trauma/injury. There are some individuals who continue to experience headaches for several months after the injury. Any injury to the head leads to swelling and accumulation of fluid in and around the brain; and when the tissues start to swell and increase in size, it causes increased pressure inside the skull (intracranial pressure) and this result in a post-traumatic headache. Men are more likely to suffer from a head injury than women. African Americans are at a higher risk to suffer from injury to the head than other races. Head injuries are also commonly seen in individuals aged 16 to 30 and individuals aged 60 to 70.
Causes of Post-Traumatic Headache
There are many injuries which could cause post-traumatic headache. Given below are some types of injuries which could result in a post-traumatic headache.
- Injuries as a result of physical violence.
- Falling and hitting the head.
- Road accidents.
- Sports injuries.
Symptoms of Post-Traumatic Headache
- Patient experiences pain in the head and neck region.
- Worsening headache upon exertion, bending over, coughing and head movements.
- Pain can occur on one side of the head or on both the sides.
- It can be throbbing in nature resembling a migraine headache with nausea and photosensitivity and sensitivity to noise.
- Vision changes.
- Problems with memory.
- Impaired hearing.
- Decreased appetite.
- Decline in smelling and tasting ability.
- Difficulty concentrating.
- Sensitivity to light and noise.
- Anxiety, depression and insomnia.
- Stiffness in the head, neck, shoulders and back.
- Decreased libido.
Investigations for Post-Traumatic Headache
- Physical exam.
- Neurological exam
- Imaging studies such as CT scan and MRI scan to assess the extent of damage to the brain structures and to rule out intracranial bleeding.
- EEG is also done.
Treatment for Post-Traumatic Headache
Treatment of post-traumatic headache comprises of addressing the symptoms with:
- Medications such as tricyclic antidepressants, like amitriptyline, help in alleviating not only the pain, but also depression and anxiety.
- If the headaches worsen and develop typical features of migraine, then migraine medications, such as sumatriptan (Imitrex), are given.
- NSAIDs also help in relieving pain and inflammation.
- Beta-blockers also help.
- Heat/ice packs can also give relief from the headache.
- Local injections given to muscles and joints of the cervical spine help in reducing the headache.
- Massage therapy also helps.
- Other therapies such as meditation, relaxation techniques, getting enough sleep, biofeedback, acupuncture are also beneficial.
Lifestyle Modifications for Post-Traumatic Headaches
- Eating healthy.
- Exercising daily.
- Quitting smoking and abstaining from alcohol.
- Avoiding foods which trigger headaches such as caffeine, red wine, MSG and some cheeses.
- Sleeping on time and getting adequate sleep.