Can a Concussion Cause Persistent Migraine Headaches?

Curated by Claudia Shannon / Research Scientist / ishonest

A concussion is a mild traumatic brain injury (TBI) resulting from a direct blow to the head or whiplash-type motion. This type of injury can damage your brain’s physical or chemical structure.

The symptoms you might experience in the days or weeks following a concussion are collectively called post-concussive syndrome (PCS). You’re more likely to have PCS if you’ve had multiple concussions.

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A migraine headache is one type of intense recurring headache. It’s usually felt on just one side of your head, but this is not always the case for everyone.

Migraine headaches are one symptom of PCS, and in some cases they can be persistent.

What causes persistent migraine headaches after a concussion?

Headaches are common after concussions. The causes aren’t fully understood, but they’re often attributed to lingering damage from the injury. The damage could be to your brain, skull, or neck.

A post-traumatic headache (PTH) is considered persistent if it continues more than 3 months after a TBI.

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A 2017 study found that 51 percent of people with a TBI experience headaches within the following 2 weeks. After 3 months, 23 percent had persistent headaches. Persistent headaches were more common in women and in people who visited the emergency department for headaches.

Two separate studies in 2018 and 2020 showed that people with PTH had less gray matter, by thickness and volume respectively, in many areas of the brain shortly after the injury compared to control groups.

Symptoms of chronic migraine headaches after a concussion

A migraine headache is a distinct type of headache. Knowing the symptoms can help lead to faster diagnosis and treatment. The symptoms of migraine attacks include:

  • intense headache
  • a throbbing or pulsing sensation, often limited to one area on the head
  • sensitivity to light, sounds, or smells
  • nausea or vomiting
  • worsening pain from light physical movement (such as walking)
  • fainting
  • blurred vision or vision loss

How long do migraine headaches last after a concussion?

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Post-traumatic headaches will vary from person to person. More research is needed to determine how different people will be affected.

A 2014 study suggested that most people with PTH will experience headaches daily or weekly, while only some people will have headaches less frequently. Each episode usually lasts from a few minutes to a few hours.

How to treat post-concussive migraine headaches

Scientists are still researching whether post-traumatic migraine headaches might benefit from distinct treatment plans. For now, post-concussive migraine headaches are treated using the same methods as migraine attacks that are not caused by concussions.

There are a wide range of treatments for migraine headaches. Some are home remedies, while others may require a medical professional.

Home remedies and over-the-counter medication
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Limiting your physical activity and getting rest are the most common recommendations from doctors. Bed rest is sometimes recommended, but not as often.

A lifestyle change may be part of your treatment plan. This could include avoiding alcohol or maintaining a healthy diet.

Medications like acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat post-traumatic migraine headaches. These are widely available over-the-counter medications.

Vitamin and herbal supplements can also be used to help manage migraine attacks. These might include:

  • magnesium
  • feverfew
  • vitamin B2
  • CoQ10
  • petasites
Medical treatment
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Triptans are a class of medication often used to treat migraine pain. They help to shrink swollen blood vessels in the brain. Triptans have to be prescribed by a doctor.

Other prescription migraine medications include:

  • ergotamines
  • antimetics
  • tricyclic antidepressants
  • barbiturates
  • opioids

Prescription drugs can have a variety of risks and side effects. Some, such as opioids and barbiturates, pose a high risk of dependence and altering your mood. These are prescribed much less frequently.

Be sure you tell your doctor about any home remedies you are using to make sure they won’t interfere with your prescriptions.

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Monoclonal antibodies are a more recent form of migraine treatment that a doctor may recommend. A 2017 review found that this method is effective, but the long- term effects are still unknown.

Botulinum toxin, or Botox, is sometimes used to prevent migraine attacks. It requires several injections to the head and neck.

Surgeries for post-traumatic migraine headaches are rare, used in only 1.5 percent of cases.

When to see a doctor if you continue having migraine headaches following a concussion

If you believe you’ve just had a concussion, seek immediate medical care.

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After receiving care for a TBI, if your headaches become more frequent or intense, or don’t go away on their own, speak with a doctor right away. They might change your treatment plan or refer you to a specialist like a neurologist.

Can you prevent post-concussive migraine headaches?

A 2019 study found that there’s not enough quality research into preventing post-concussive migraine headaches. Sometimes anti-seizure and high blood pressure medications are used, as well as antidepressants.

It’s possible to take too many pain medications and develop medication-overuse headaches (MOH), so be sure to consult with a doctor if feel you need to increase your use of pain relievers.

A 2018 study showed that a number of methods could be used to reduce persistent PTH frequency and severity. These approaches might help to prevent an acute PTH from becoming persistent:

  • drinking electrolytes
  • maintaining a stable sleep schedule
  • cognitive-behavioral therapy
  • biofeedback
  • meditation
  • reducing the use of multiple headache pain medications when possible
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The best way to prevent post-traumatic migraine headaches is to prevent traumatic brain injuries to begin with. The CDC recommends:

  • wearing a seatbelt
  • driving only when sober and alert
  • wearing appropriate headgear for sport and recreational activities
  • preventing older adult falls
  • using child safety gear in living and play spaces

Other symptoms of post-concussive syndrome

Migraine headaches are only one symptom of PCS. You may have PCS without experiencing migraine headaches. Research from 2020 found that other symptoms of PCS can include:

  • memory loss
  • low ability to focus
  • confusion
  • speech difficulty
  • irritability
  • tinnitus
  • fatigue
  • insomnia
  • sensitivity to light or noise
  • mood problems
  • suicidal ideation

Takeaway

Headaches, and especially migraine headaches, are common after traumatic brain injuries like concussions. Persistent migraine headaches in particular can have a big effect on your quality of life.

Fortunately, treatments for migraine have been well researched, and there are many options available. If you are having migraine headaches as a result of a concussion, speak with a doctor about a treatment plan.

Read more on: migraines


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