Headache

Key points :

  • Headache following a mild head injury is very common
  • The exact mechanism as to why headache occurs after mild head injury is unclear but the trigger is a blow to the head and the headache usually develops within 7 days
  • Headaches can last for a long time and be frightening, but this reassuringly does not imply a worrying or serious underlying cause
  • Headaches do improve, but it can take time
  • It is important to try and continue life as normal and to remain positive

Types of headache

  • There are many different types of headache
  • The commonest types of headache that occur following a mild head injury are migraine and tension-type headache
  • Some people have either migraine or tension-headache, some experience both
  • Headaches can be episodic (i.e. come and go) or chronic (occur on most days, sometimes all day)
  • Most headaches following a mild head injury resolve by 3 months but some people continue to experience headaches beyond this point which is labelled as chronic daily headache

> Find out more about these types of headache

Do I need any more investigations?

Generally, no. Your doctor will take a detailed history and perform a focussed examination. If they do not organise a scan, that is because they are confident about the diagnosis. Keeping a headache diary and correlating it with painkiller use can help doctors to decipher what kind of headaches you are having and whether there is medication overuse headache present.

> Read more about the assessment of head injuries

What Treatments Are Available?

There are many treatments available for the management of headache such as migraine and tension-type headache. These are divided into ACUTE (i.e. medication taken for acute relief) and PREVENTATIVE (medication taken to help reduce the severity and frequency of headaches). Your doctor will know what type of treatment is most suitable for you depending on your allergies, medication and other medical conditions.

Acute treatments include drugs such as aspirin, ibuprofen and paracetamol. Preventative treatments include a type of antidepressant called amitriptylline or a blood pressure tablet called propranolol.

> Read more about medication

What Can I Do to Help Myself Get Better?

  • Having a realistic expectation is important
  • Headaches do improve BUT it is not an overnight fix and does take time
  • It is important to feel satisfied about the diagnosis and allow your doctor to reassure you
  • Many people find themselves in a vicious cycle of symptoms:
  • Keep a headache diary- it will allow you to monitor your own improvement
  • You might want to stop regular painkillers – they can cause or worsen chronic headache
  • Improve your sleeping habits
  • Address any stress/low mood/worry– this is well known to exacerbate and heighten any chronic pain, including headache
  • Don’t skip meals and keep well hydrated
  • Stay positive – things will get better
  • Live life as normally as possible
  • Accept that you will have good days and bad days – this is normal

Further Reading

Migraine Trust – The Migraine Trust is an organisation providing information and promoting research on migraine to reduce its burden on sufferers.

Download the patient information leaflet on Chronic Daily Headache