According to the American Council for Headache Education, it is estimated that there are over 450,000 new cases of chronic post-traumatic headache in the United States each year.
Post-traumatic headache is head pain that follows significant head trauma or injury, defined by at least one of the following criteria:
- Loss of consciousness
- Post-traumatic amnesia that lasted more than 10 minutes
- Relevant abnormalities confirmed by two or more of the following tests: clinical neurological examination, skull X-ray, CT scan, MRI, evoked potentials, spinal fluid examination, vestibular function studies, neuropsychological testing
Approximately 70-90% of people who suffer from a whiplash accident develop headaches.
Post-Traumatic Headaches: Symptoms
The symptoms of post-traumatic headache include the following:
- Headache usually begins immediately or shortly after the injury.
- Pain is generalized, meaning the headache is felt all over the head and frequently in the neck.
- Pain is characterized as aching, throbbing, pounding, pressure, squeezing, stabbing, or expanding.
- Headaches are very intense and at times incapacitating.
- Headaches are likely to be worsened by mental or physical activity.
In addition to chronic headache, the following symptoms are also associated with a closed head injury:
- Personality change
- Impaired memory
- Impaired concentration
- Reduced attention span
- Easy distractibility
- Dizziness or lightheadedness
- Irritability and anger outbursts
- Mood swings
These symptoms can range in severity from being quite subtle to being very obvious to both the patient and others.
Post-Traumatic Headaches: Diagnosis
Post-traumatic headache is most easily diagnosed when there is evidence of trauma in the form of a fracture or the presence of focal signs, but in many cases there is no such evidence. It is necessary then to establish the onset of the headaches as occurring after an accident. This is determined during the initial exam and review of the patient’s medical history.
Post-traumatic headache is often one of several symptoms of the post-concussive syndrome, and therefore may be accompanied by additional cognitive, behavioral, and somatic problems. As part of the diagnostic process, your doctor may conduct a variety of neurological and imaging tests to rule out other disorders.
Post-Traumatic Headaches: Treatment
With appropriate medical treatment about 80% to 85% of patients with chronic post-traumatic headache can gain reasonable control of their headaches within 6 to 12 months.
Treatment varies widely depending on the nature and severity of the injury. Biofeedback, physical therapy, and psychotherapy have been shown to provide effective treatment for post-traumatic headache sufferers. Additionally, a variety of medications are available including beta blockers, antidepressants, calcium channel blockers, anti-seizure drugs, serotonin antagonists, or intravenous DHE. Blocking the occipital nerve with a local anesthetic (usually lidocaine) combined with a corticosteroid (such as dexamethasone) may also provide short-term pain relief.
Post-Traumatic Headaches: Resources
NIH Neurological Institute
P.O. Box 5801
Bethesda, MD 20824
Voice: (800) 352-9424 or (301) 496-5751
TTY (for people using adaptive equipment): (301) 468-5981