Post-Concussion Headaches: Cause & Treatments

concussion headacheConcussions have been a recent hot topic in the news and in medicine. But for Neurologists and Physical Medicine physicians, this is actually a very old topic.   Recently, due to high profile athletes having problems with concussions, the general public is better understanding the significance of this disorder.

What is a Concussion?

Concussions are traumatic brain injuries.  The severity of symptoms is highly varied.  Neurologists have long been in the forefront with diagnosis of brain injuries and Physical Medicine doctors as part of their training have extensive experience treating and coordinating care for these patients.

Concussions result from blows to the head.   They are a “mild” form of traumatic brain injury.  Loss of consciousness is not necessary for problems.  The severity of the blow to the head also does not correlate to severe symptoms.   Any blow to the head, or sudden shaking of the head can cause problems.  The trauma to the brain is felt to cause microscopic damage to the brain and connections between neurotransmitters.  The first symptoms may occur almost immediately with the person being slightly dazed or confused.  Recognizing a possible concussion is important such that a person is removed from further injury and healing can be facilitated.

Concussion Headaches

Headaches are one of the most common symptoms of concussions.  The headaches are diffuse throughout the head, and often are worse with noise, bright light, and movement.  Accompanying symptoms can include:

  • Memory issues
  • Mood changes
  • Irritability
  • Fatigue
  • Balance problems and dizziness

The symptoms can appear immediately or within one to two weeks.  If one has had head trauma, and has symptoms of a possible concussion, see a physician and seek treatment.  Remember, the suggestion to seek evaluation is to help the brain heal and prevent further damage.  It is not a punishment to keep a person out of sports or other activities.

The diagnosis of concussion and headaches from injury is made clinically; it is based on history and exam.  MRI scans of the brain or spine may be done to evaluate for possible problems contributing to symptoms or to see if there may be subtle tissue changes in the brain that are consistent with exam.  If dizziness is an issue, then an Ear specialist may also be involved with symptom evaluation and management.

Concussion Headache Treatment Options

Treatment of post–concussion syndrome and headaches is dependent on severity of symptoms.  Initially, it is recommended to rest and avoid too much activity and stimulation to the brain.  That may mean no computer use, no reading and no watching TV or videos.  As the headaches improve, gradual increase in activity as tolerated.  The brain needs to heal on its own time frame without being damaged or stressed.  Medications that are used are the same medications we use for muscle tension headaches or migraines, but we start simple and hopefully they will be unnecessary very quickly.  Repeated concussions often heal very slowly if ever.

Concussions and headaches from them are serious problems.  Medicine and everyone else is just starting to become aware of the seriousness of these injuries.  Treating ongoing headaches from concussions is serious; ignoring them may lead to long-term issues.  Once a diagnosis is made, follow the doctor’s orders and allow the brain to heal.  There is no such thing as brain transplants, so allow the brain time to heal.

For more information on headaches, check out our other posts: