Why Do I Have Headaches After a Brain Injury?
Post-traumatic headaches very often occur after a brain injury. Unfortunately, these headaches usually become chronic, which means they never go away. Treatment of these headaches can be difficult because of the cognitive, emotional, and physical problems caused by the brain injury. Headaches following a brain injury can occur from multiple causes. First, swelling of the brain from the injury, called cerebral edema, is known to cause headaches. Second, the same force that caused the traumatic brain injury can also put pressure on the neck (cervical spine) and the nerves that lead to the brain. This pressure also causes headaches. These forces can include car crashes, trucking crashes, or assault.
What do different types of headaches after a brain injury mean?
The International Classification of Headache Disorders published its 3rd classification in 2018. They call it a “field guide” to headaches. According to the ICHD, “primary headaches” are caused by disease entities, while “secondary headaches” are a manifestation of other disease processes. Primary headaches include: tension-type headaches, migraines, and trigeminal autonomic cephalgia. Secondary headaches include post-traumatic headaches.
In general, post-traumatic brain injury headaches typically start within 7 days of the brain injury. For post-traumatic headaches within the first 3 months of the brain injury, the term “acute” is used. These headaches then become “chronic” if they continue to exist more than 3 months after the injury.
For people who have no past history of traumatic head or brain injury or headaches, a diagnosis of post-traumatic headaches is simple. Did you sustain a traumatic brain injury? Do you have headaches? If the answer to both is yes, the diagnosis is made. For those who have a prior history of primary headaches, though, the diagnosis is more difficult. If you have a history of prior primary headaches, but now your headache is worsened in intensity and frequency, a post-traumatic headache may be diagnosed. While there is no clinical testing that can diagnose this, a neuropsychological test can help determine the validity of the complaints.
What should I do if I have post-traumatic brain injury headaches?
The most important thing you can do is get treatment for your brain injury headache. This includes going to the hospital, if necessary. The emergency room doctor or your primary care doctor can refer you to a neurologist for further workup. Neurologists commonly treat these headaches and will know the right type of testing to order. Do not simply take Tylenol or Advil and hope the headache goes away. Sometimes the headache can be a sign or symptom of a more severe brain injury. Once the headache becomes chronic, it is very difficult to treat. It is therefore very important to intervene as quickly as possible.