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Headaches After Brain Injury: Types, Causes, and Treatments

understanding headaches after brain injury

Headaches after brain injury, also known as post-traumatic headaches, are probably the most frequent physical effects of brain injury.

Even though they are common, headaches after brain injury can be particularly tough to treat. One reason is because there are many different types of post-traumatic headaches.

To help you find relief from your headaches, we’re covering everything you need to know about headaches after TBI, including the best treatments and lifestyle changes that will lessen their severity.

Sound good? Let’s get started!

Causes of Headaches after Brain Injury

Before you can effectively treat your headache, it will help to know what’s causing the pain in the first place.

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

Sometimes genetics can also cause 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 Headaches after Brain Injury

How you treat your headache will depend on what type of headache it is.

There are four main headaches you can experience after brain injury:

  • Tension headaches
  • Cervical headaches
  • Migraines
  • Neuralgic pain

Tension headaches

Woman putting hand on head because of her tension headaches after brain injury

These types of headaches often feel like something tight is squeezing your head. They are caused by tightness in your jaw and facial muscles.

This squeezing sensation can surround your entire head, but most of the time, you’ll feel it on your temples.

Tension headaches are the mildest forms of headaches, and they tend to happen later in the day.

Stress makes these headaches much worse.

Cervical headaches

Cervical headaches can feel a lot like tension headaches. The difference they 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 almost always accompany a TBI. This makes cervical headaches one of the most common types of headaches after brain injury.

You can usually tell you have a cervical headache if your neck position makes the pain worse or better.

What’s strange about cervical injuries though is that they share the identical symptoms of concussion, including nausea, dizziness, and memory problems.

This means sometimes the problems you experience after your injury could all be from your neck, not your brain.

That’s why it’s always a good idea to get your neck checked out by a specialist if you’ve been in an accident. It could save you a lot of pain and trouble.


Man lying in bed suffering from a migraine after TBI

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 usually followed by nausea, dizziness, and light sensitivity. Despite their severity, migraines are not dangerous.

You should call your doctor immediately, however, if you experience any of these symptoms with your migraine:

  • Fever
  • Double vision
  • Seizures
  • Numbness
  • Slurred speech
  • Stiff neck

Neuralgic pain

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

You can tell if you have a neuralgic headache by 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 pain that feels like a sharp, electric shock directly behind your eyeballs. You can 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 of them.

Your joint injury could pinch the nerves in your spine, causing you both cervical and neuralgic pain. The pain could also cause your muscles to tighten up, leading to a tension headache on top of everything.

The problem is, when you are suffering from more than one type of headache at once, the symptoms can become blended. But if you aren’t able to identify the cause of your pain, it will be almost impossible to manage the pain.

That’s why it’s so important to be thorough and specific when describing your headache pain to your doctor. It will help them make the right diagnosis and offer you the most effective treatment.

So what do you need to do to help your doctor understand your pain?

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 have a much better chance of getting the right treatment than if you simply tell them your head hurts.

Treatment for Headaches After Brain Injury

While each type of headache will need something a little different, here 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 work, so staying awake can overwork it 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, so drinking enough water is crucial if you want to keep 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, so it’s best to avoid it until you 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.

Other treatments

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

Most treatments will revolve around relieving tension and stress, since those are common headache triggers. Bio-feedback therapy and meditation are two effective ways to reduce stress in your life.

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

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, it’s most likely because you have a joint or nerve injury that you never took care of.

Cervical headaches tend to last the longest, because most people are so focused on their brain after a head injury they forget about their neck.

Headaches After Brain Injury: Conclusion

While headaches are the most common side effect 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, thinking this is just 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, so you can get the right treatment as soon as possible.

We hope this article helps you find the treatments you need to finally enjoy life again without headaches holding you back.

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