Post-Traumatic Headache - The Basics

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Post-traumatic headache (PTH) is headache that occurs after an injury. Most commonly, it occurs following a head injury, but it can also occur after a neck trauma, after a craniotomy, after a whiplash injury, or because of a traumatic hematoma. Because post-traumatic headache is caused by another condition, head and/or neck injury, it is considered a secondary headache disorder.

Post-traumatic headache is somewhat controversial thanks to our litigious society:

"Post-traumatic headache, defined as headache following head trauma, is one of the most controversial types of headaches. Some experts believe that it has been fabricated by lawyers and greed. Others consider it a biological disorder resulting from permanent brain or nerve injury. No one can deny that it generates a huge amount of medical, legal, and insurance company activity."2

Like other headache disorders, PTH has both acute and chronic forms. Chronic forms of Migraine and headaches are those in which Migraine or headache occur 15 or more days per month for three months or longer.

PTH may be accompanied by photophobia, phonophobia, nausea, and other symptoms usually associated with Migraine. It's also common for people with PTH to experience:

  • balance problems
  • memory problems
  • concentration problems
  • shortened attention span
  • problems performing multiple tasks at the same time
  • vertigo
  • sleep disturbances
  • acquired intolerance to alcohol

Diagnosis of PTH can be complicated and delayed by the patient's dismissing a minor head injury and not reporting it. PTH can be caused by a mild concussion that doesn't result in loss of consciousness. Many of this type of injury go undiagnosed and untreated because the patient has a blow to the head that seems minor to them, and they don't realize it has caused a concussion.

PTH has been known to trigger Migraine attacks and in a few patients, a cluster-like syndrome has been reported.1

There is no specific treatment for post-traumatic headache. PTH is sometimes an exception to the rule that Migraine abortive medications only work for Migraine attacks. For chronic PTH, medications use for the prevention of Migraines and other headaches may help reduce the frequency and severity of PTH.

In the International Headache Society's International Classification of Headache Disorders, 2nd Edition (ICHD-II), there are several subtypes of post-traumatic headache.2

5.1 Acute post-traumatic headache

5.1.1 Acute post-traumatic headache attributed to moderate or severe head injury 5.1.2 Acute post-traumatic headache attributed to mild head injury

5.2 Chronic post-traumatic headache

5.2.1 Chronic post-traumatic headache attributed to moderate or severe head injury 5.2.2 Chronic post-traumatic headache attributed to mild head injury

5.3 Acute headache attributed to whiplash injury

5.4 Chronic headache attributed to whiplash injury

5.5 Headache attributed to traumatic intracranial haematoma

5.5.1 Headache attributed to epidural haematoma 5.5.2 Headache attributed to subdural haematoma

5.6 Headache attributed to other head and/or neck trauma

5.6.1 Acute headache attributed to other head and/or neck trauma 5.6.2 Chronic headache attributed to other head and/or neck trauma

5.7 Post-craniotomy headache

5.7.1 Acute post-craniotomy headache 5.7.2 Chronic post-craniotomy headache

Resources:

1 The International Headache Society. "The International Classification of Headache Disorders, 2nd Edition." (ICHD-II) September, 2004. www.i-h-s.org.

2 Young, William B.l Silberstein, Stephen D. "Migraine and Other Headaches." St. Paul, Minnesota: AAN Press, 2004.

For information on other types of Migraines and headaches, please see:

Medical review by John Claude Krusz, PhD, MD