Headaches After a Head Injury: Causes and When to Worry

Post‑traumatic headaches are common and can stem from several mechanisms:

1. Concussion (Mild TBI)

• Headache, nausea, dizziness, confusion, memory issues, sleep disturbance.
• May last days to weeks; usually resolves with rest and gradual return.

2. Post‑Concussion Syndrome (PCS)

• Persistent headaches, fatigue, cognitive difficulties, mood changes >3 months.
• Requires multidisciplinary management (neurology, PT, neuropsychology).

3. Migraine (Triggered or Exacerbated)

• Throbbing, unilateral, photophobia/phonophobia, nausea.
• Trauma can unmask or worsen underlying migraine disorder.

4. Tension‑Type Headache

• Band‑like pressure, pericranial tenderness; stress/posture related.

5. Other Causes

• Cervicogenic headache (neck injury referral)
• Medication overuse headache (from frequent analgesics)
• Intracranial hemorrhage (subdural/epidural) – emergency

Red Flags – Immediate Evaluation

• Worsening headache, vomiting, seizures, focal deficits
• Altered consciousness, unequal pupils
• Headache awakening from sleep
• On anticoagulants or bleeding disorder

See a clinician after any head injury with headache. Imaging (CT/MRI) indicated for red flags or persistent symptoms.