Dear Dr. Haplea,

I was working at a State Prison and was attacked by an inmate. He hit me on the back of my head and I have had migraines ever since. I have seen many doctors but nobody can help me; they put me on morphine for 3 years but it did not help, and now I am on Relafen 500mg but it does nothing. I go to bed with headaches and wake up with headaches. What other alternatives are out there? Should I be taking a different course of action since my migraines seemed to start with this trauma?

Post-traumatic migraine headaches may be difficult to treat; however, many of the same preventive migraine medications that are used for common or classic migraine headaches may reduce the frequency and intensity of post traumatic migraine headaches. I would recommend an evaluation with a neurologist and a trial of a preventive medication (anti-seizure medications, antidepressant medications, and/or antihypertensive medications) as opposed to treating with abortive medications alone such as Relafen and morphine. When one of my patients has more than one migraine headache a week, I recommended a preventive medication in addition to an abortive medication.

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