By definition, post-traumatic headache occurs after head trauma. The headaches typically begin within seven days of the inciting trauma, which can range from mild to severe.
Although the characteristics and associated symptoms of post-traumatic headaches vary, there is substantial overlap with the symptoms of migraines or tension headaches. The headaches can be mild, moderate, or severe. They may resemble a migraine, affecting one side of the head, or a tension headache, affecting the entire head. Neck pain is very common. The quality of the pain may be described as throbbing, pounding, pressure-like, squeezing, a dull ache, or stabbing. Cutaneous allodynia—where normally nonpainful stimuli on the skin are perceived as painful—is present in one-third of those with post-traumatic headaches. Photophobia, phonophobia, nausea, fatigue, and decreased concentration are also common. The frequency and severity of the headaches are variable; they can be intermittent or continuous, and may be triggered or worsened by physical exertion, mental concentration, or excessive environmental stimuli.
Medications used to treat post-traumatic headaches are typically taken as needed. The choice of medication depends on the nature of the headaches and associated symptoms. Over-the-counter analgesics (Tylenol, ibuprofen, Advil, Aleve, Excedrin, etc.) are effective in the majority of cases. Activities and situations that trigger or worsen the headaches should be avoided or minimized if possible. Management of post-traumatic headaches should be coordinated with treatment for other symptoms related to head trauma, such as decreased cognition, sleep disturbances, and mood changes.
The majority of post-traumatic headaches resolve within a few days to several weeks. However, about one-third of individuals may experience persistent headaches of varying intensity. Regular follow-ups with medical providers are important to help manage and reduce the headaches.