Treatment. Post-Traumatic Headache

Post-traumatic headache diagnosis

Many times, post-traumatic headaches are not recognized immediately following mild trauma. Therefore, if you have suffered a mild concussion, you may not be seen in a clinic or emergency room. If you are seen by a doctor and diagnosed with a concussion or traumatic brain injury, your doctor may refer you to the consultation of a neurologist for specialized treatment. A neurologist is a physician who specializes in the treatment of disorders of the brain and nervous system.

When you see a physician for headaches following a concussion or other trauma, you can help ensure you get the best care possible by being prepared to answer some questions the doctor may ask you. Answer the following questions, write answers down and take them along with you to your appointment:

• What symptoms are you having?
  • When did your headaches start? Have they gotten better, worse, or stayed the same?
  • What does your headache feel like? (Sharp, dull, throbbing, splitting, etc.)
  • Is your pain constant, or is it recurrent? Do you have a headache every day?
  • What makes your headache better, and what makes your pain worse?
  • Other than your headache, what other symptoms do you have? (dizziness, trouble sleeping, memory problems, anxiety, etc.)
• What type of accident or trauma did you experience, and when did it occur?
• What medications are you taking?
  • Make a list of all prescription drugs you take and all over-the-counter medications, herbal supplements, and vitamins, even if you don’t take them every day.
  • Write down the name and phone number of your primary doctor and your pharmacy.
  • Write down any allergies you have to food, medications, or substances.
• What other medical problems are you being treated for?
• Have you experienced any significant changes in your life or stresses since your injury? A new job, a divorce, death in the family, etc.

It’s better to have a list of questions you want to ask the doctor, and you may also ask a friend or a family member to go with you to your appointment to help you remember any information you may have forgotten.

Diagnostics of post-traumatic headaches

No test is available that can diagnose a post-traumatic headache, but your doctor may recommend imaging studies to rule out other possible conditions that could cause headaches. These may include a magnetic resonance imaging (MRI) scan or a computerized tomography (CT) scan.

• If your physician suspects a problem with your ears, nose, or throat, you may be referred to a doctor specializing in this field.
• If a problem in the spinal vertebrae of your neck is suspected, you may be referred to a spine specialist. 
• Your doctor may refer you to a psychiatrist or psychologist if you have depression, anxiety, or problems with concentration or your memory, in addition to post-traumatic headaches.

Medications for post-traumatic headache treatment

There is no one medication specifically recommended for the treatment of post-traumatic headaches. The same types of drugs used to treat tension or migraine headaches are often effective in treating post-traumatic headaches, so these are often prescribed, depending on a person’s symptoms.
Examples of medications used to treat post-traumatic headaches include:

• Amitriptyline: This medication is an antidepressant, but it is also used in the treatment of post-traumatic injuries. Sometimes it is used in combination with propranolol (a blood pressure medication) to treat other types of headaches, such as migraines.
• Topiramate: This is an anti-seizure medication that is often used to treat migraine headaches, but it is sometimes helpful in relieving post-traumatic headaches.
• Gabapentin: This is also an anti-seizure drug. It is effective for many types of pain and may help relieve post-concussion syndrome pain.

If you use prescription or over-the-counter pain relievers for post-traumatic headaches or other types of pain, be sure to take these exactly as directed and do not exceed the recommended dosages. Overuse of these drugs may lead to “rebound headaches.”

When to see your doctor

If you have a head injury and experience confusion or difficulty remembering, see your doctor or another medical professional, even if you never passed out. The severity of an injury is not always related to the development of complications later.
If you suffer a concussion while you are playing in a game, don’t return to the activity until you’ve been evaluated by a physician.

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