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Headaches After Brain Injury: Types, Causes, and Treatments

woman with hands on temples struggling with headache after brain injury

Headaches after brain injury, also known as post-traumatic headaches, are one of the most frequent physical effects of brain injury. In fact, about 30% of traumatic brain injury patients experience them during the first year of recovery.

To help you find relief from your headaches, this article will discuss the different types of headaches after TBI plus the best treatments that can help lessen their severity.

You can use the links below to jump to any section:

Causes of Headaches After Brain Injury

In order to effectively treat your headache, you must identify the cause of your pain. Headaches after brain injury can occur for several reasons, including:

  • Pain from surgery
  • Small collections of blood or fluid on the brain
  • Inflammation
  • Muscle tension
  • Nerve damage or pinching
  • Vision changes, such as double vision

In addition, sometimes genetics can lead to headaches after an injury. For example, if you were already prone to migraines before your injury, chances are very high you will experience them afterward.

Types of Post-Traumatic Headaches

Besides understanding the cause, it is also helpful to distinguish between the types of headaches you might have.

For example, there are four main types of headaches you can experience after brain injury:

  • Tension headaches
  • Cervical headaches
  • Migraines
  • Neuralgic pain

We will examine each type in more detail below:

1. Tension headaches

Woman putting hand on head and closing her eyes because of her tension headaches

These types of headaches often feel like squeezing inside your head. They are caused by tension in your jaw, facial, and neck muscles.

This squeezing sensation can surround your entire head, but most of the time, you will feel it around your temples.

Tension headaches tend to be the mildest forms of headaches, and they tend to happen later in the day. In addition, stress makes these headaches much worse.

2. Cervical headaches

Cervical headaches can feel a lot like tension headaches. However, they typically occur after an injury to the joints in your neck. Most people know these injuries as whiplash.

Because most traumatic brain injuries occur after a car crash or some other sudden impact, neck injuries often accompany a TBI. This makes cervical headaches one of the most common types of headaches after brain injury.

If your neck position makes the pain worse or better, then you most likely are experiencing a cervical headache. To find relief, have your neck checked out by a specialist. They can realign your cervical joints, which may eliminate your headaches.

3. Migraines

Man lying in bed suffering from a migraine, a common type of headache after brain injury

Migraines are one of the worst types of post-traumatic headaches. They occur when part of the brain is inflamed.

This inflammation changes the way the blood flows to the brain, resulting in the dull, throbbing sensation most commonly associated with migraines.

Sometimes before a migraine hits you will get a warning sign such as strange spots in your eyes. Doctors call this an aura.

Migraines are often accompanied by nausea, dizziness, and/or light sensitivity. Despite their severity, however, migraines are not dangerous.

4. Neuralgic pain

Sometimes your injury will damage the nerves in your head and upper neck, which can lead to headaches as well as numbness and tenderness on the scalp.

The defining feature of a neuralgic headache is the stabbing or shooting pain it causes. Most people describe it as an ice pick digging into their skull.

The most common type of neuralgic headache is occipital neuralgia. This happens when an injury inflames your occipital nerves, the nerves that run from your spinal cord to the back of your scalp.

One of the hallmarks of occipital neuralgia is a shooting pain that feels like a sharp, electric shock directly behind your eyeballs. You may also feel it on the back of your head and neck.

Diagnosing Headaches After Brain Injury

Kind doctor listening to patient describe their headaches after brain injury

Most of the time, you won’t just experience one type of headache or another, but a combination.

For example, your joint injury could pinch the nerves in your spine, causing you both cervical and neuralgic headaches. The pain could also cause your muscles to tighten up, leading to a tension headache as well.

Unfortunately, when you are suffering from more than one type of headache, the symptoms can blur together. And if you aren’t able to identify the cause and type of your headaches, it will be much more difficult to manage the pain.

Therefore, it is crucial to be thorough when describing your headache pain to your doctor. It will help them make the right diagnosis and offer you the most effective treatment.

Remember C.O.L.D.E.R.

Dr. Nathan Zasler, a headache specialist at the Concussion Care Centre of Virginia, recommends his patients use the acronym C.O.L.D.E.R to remember what details to explain about their headaches:

  • Character: Describe what the headache feels like. Is it a throbbing pain or more of a squeezing headache? Is it sharp or dull?
  • Onset: How does the headache start? Do you feel it slowly come on or is it sudden and painful? Does it happen at a certain time of day or after you make a sudden movement? Or does it seem random?
  • Location: Where does it hurt? All around your head or just in one area?
  • Duration: How long do the headaches last?
  • Exacerbation: Does anything make the headache worse? Maybe bending your neck forward, for example?
  • Relief: Does anything make the headache lessen or feel better?

If you can give your doctor the answers to these questions, you will have a much higher chance of getting the right treatment than if you simply tell them your head hurts.

Treatment for Headaches After Brain Injury

concerned husband handing wife pill to help her headaches after brain injury

While each type of headache will require a different regimen, the following are some general lifestyle changes that can help you manage the pain:

  • Get enough sleep. Sleep is when your brain does most of its repair after an injury. This means staying awake can overwork the brain and delay the healing process, which will make your headaches worse.
  • Exercise daily. Aerobic exercise releases endorphins that act as your body’s natural painkillers. This means exercise can ease some of the pain from headaches.
  • Stay hydrated. Dehydration can trigger migraines. Therefore, drinking enough water is crucial to keep migraine headaches at bay. Staying hydrated also helps your brain heal itself faster, which will help ease your headaches.
  • Avoid foods that trigger headaches. Some foods can trigger headaches, such as foods that contain artificial sweeteners or MSG. Alcohol can also make headaches worse. As a result, it’s best to avoid these foods and beverages until you can get your headaches under control.
  • Avoid heavy medication. Opioids and other strong medications are sometimes used to treat severe headaches, but if you’ve had a brain injury, you should not take those. Painkillers suppress brain function, which can be dangerous for TBI patients.

Too much medication can also cause rebound headaches, where the headaches return worse than before. That’s why doctors recommend trying other treatments before starting meds.

If you absolutely must take heavy medication, make sure it’s under the close supervision of your doctor. Do not self-medicate.

Alternative Treatments for Post-Traumatic Headaches

Sometimes lifestyle changes like the ones above are enough to stop most headaches. But if these changes don’t relieve your headaches, do not fret. There are still several other options that can help you.

Most treatments will revolve around relieving tension and stress since those are common headache triggers. For example, biofeedback therapy and meditation are two effective ways to reduce stress in your life, which can in turn treat your headaches.

In addition, massage therapy and acupuncture can also help you find relief, especially from cervical headaches and neuralgia.

Finally, in severe cases, Botox shots can be an effective treatment for certain types of headaches. Again, talk to your doctor if you think you need something strong like that.

How Long Do Headaches after TBI Last?

doctor holding clock to demonstrate timeline

Most headaches after brain injury will last only a few weeks. However, it is possible for headaches to persist for several months and even years after an injury.

If you don’t find your headaches decreasing in frequency over time, you may have a joint or nerve injury that you need to have properly treated.

Cervical headaches tend to last the longest because neck injuries can take a while to heal. Fortunately, with manual neck therapy, these headaches can be effectively treated.

When Are Post-Traumatic Headaches Dangerous?

Most headaches after brain injury are not cause for concern. As your brain heals, they should decrease in severity and frequency.

However, there are cases when a headache can be a sign of a more serious condition. You should call your doctor immediately if you experience any of these symptoms with your migraine:

  • Fever
  • Double vision (new onset)
  • Vomiting
  • Confusion
  • Seizures
  • Numbness
  • Slurred speech
  • Stiff neck

These symptoms could be a sign of very serious conditions in your brain, such as a hematoma (a collection of blood on the brain), or a brain tumor. Because these conditions are life-threatening and usually treated with surgery, it is critical to call your doctor as soon as symptoms appear.

Headaches After Brain Injury: Conclusion

While headaches are one of the most common secondary effects of brain injury, most TBI survivors don’t realize there are effective treatments that can reduce or eliminate their pain.

Instead, many suffer from post-traumatic headaches in silence, believing this is their new normal. Or they might have tried medication and didn’t see any results, not realizing that their headaches aren’t stemming from their brain but from their neck.

That’s why it’s so important to understand the different types of headaches after brain injury. This can empower you to get the right treatment as soon as possible.

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