Persistent Headaches After Concussion: Long-Term Effects

Eight months ago, I suffered a concussion, and I am still experiencing headaches?

Dear Dr.
Gao,
The patient is my father.
He fell from a height and hit the back of his head around November last year.
He couldn't remember the events that occurred at that time.
He was immediately taken to the hospital, where he was diagnosed with a concussion.
After seeing the doctor, he was prescribed medication and monitored for three days, and ultimately, they said everything was fine.
However, he has been experiencing frequent headaches and dizziness, especially in the evenings and at night, ever since.
He has also visited the Veterans General Hospital and National Taiwan University Hospital to see a neurologist, but they all concluded that no issues were found and advised him to continue taking medication.
Eight months have passed, and it is still distressing to see my father troubled by headaches.
I would like to ask Dr.
Gao if it is normal for post-concussion symptoms to persist for such a long time.
Is there any way to reduce the severity of my father's headaches? Thank you.

Lin Cheng-Hsun, 20~29 year old female. Ask Date: 2016/06/28

Dr. Gao Chunde reply Neurology

If the neurology department of the medical center has assessed and found no issues, then this type of headache is classified as post-traumatic headache, which is a sequela.
Some individuals may experience gradual resolution over time, while others may require long-term medication management to improve their quality of life.

Reply Date: 2016/06/28

More Info

Persistent headaches following a concussion can be a challenging and distressing issue, both for the individual experiencing them and for their loved ones. Your father's situation, where he has been suffering from headaches and dizziness for several months after a fall, is not uncommon. Post-concussion syndrome (PCS) is a recognized condition that can occur after a concussion, and it can lead to a variety of symptoms, including persistent headaches, dizziness, difficulty concentrating, and mood changes.

Understanding Post-Concussion Syndrome
Post-concussion syndrome is characterized by the persistence of symptoms following a concussion, which can last for weeks, months, or even longer. The exact cause of PCS is not fully understood, but it is believed to involve a combination of physical, psychological, and social factors. The brain may take time to heal after a concussion, and during this period, individuals may experience heightened sensitivity to stress, anxiety, and other emotional factors that can exacerbate headache symptoms.

Types of Headaches After Concussion
1. Tension-Type Headaches: These are often described as a tight band around the head and can be triggered by stress, anxiety, or muscle tension in the neck and shoulders.

2. Migraine-Like Headaches: Some individuals may experience headaches that resemble migraines, with symptoms such as nausea, light sensitivity, and throbbing pain.

3. Cervicogenic Headaches: These headaches originate from issues in the neck and can be exacerbated by neck strain or injury, which is common after a concussion.

Management Strategies
While it is essential for your father to continue following up with healthcare professionals, there are several strategies that may help alleviate his symptoms:
1. Medication: Over-the-counter pain relievers like acetaminophen or ibuprofen can be effective for managing headache pain. However, it is crucial to use these medications as directed and not to exceed recommended dosages.

2. Physical Therapy: Engaging in physical therapy can help address any neck or shoulder tension that may be contributing to headache symptoms. A physical therapist can provide exercises and techniques to improve posture and relieve muscle tension.

3. Cognitive Behavioral Therapy (CBT): If anxiety or depression is contributing to your father's headaches, CBT can be beneficial. This form of therapy helps individuals develop coping strategies and change negative thought patterns.

4. Lifestyle Modifications: Encouraging a healthy lifestyle can significantly impact headache frequency and severity. This includes:
- Regular Sleep: Maintaining a consistent sleep schedule can help regulate the body's internal clock and reduce headache occurrences.

- Hydration: Ensuring adequate fluid intake is essential, as dehydration can trigger headaches.

- Nutrition: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall health and potentially reduce headache frequency.

- Stress Management: Techniques such as mindfulness, meditation, and yoga can help manage stress levels, which may, in turn, reduce headache frequency.

5. Avoiding Triggers: Keeping a headache diary can help identify specific triggers that may worsen your father's headaches, such as certain foods, stressors, or environmental factors.

When to Seek Further Help
If your father's headaches persist despite these interventions, or if they worsen, it is crucial to seek further evaluation from a neurologist or headache specialist. They may recommend additional imaging studies or treatments, such as nerve blocks or preventive medications specifically designed for chronic headaches.

In conclusion, while persistent headaches after a concussion can be frustrating and concerning, they are not uncommon. With appropriate management and support, there is potential for improvement. Encourage your father to stay proactive in his care and to communicate openly with his healthcare providers about his symptoms and any changes he experiences.

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