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
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.
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.
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, for 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
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
SIGN 107 - The Scottish Intercollegiate Guidelines Network (SIGN) provides national guidelines on various topics. This one focuses on the diagnosis and treatment of headache in adults.
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
Painkillers are not the only answer
Too frequent use of simple painkillers can cause medication overuse headache which will worsen your pre-existing headache