Headaches are among the most common symptoms following a concussion or traumatic brain injury. Although many improve within days or weeks, others persist for months or even years, sometimes becoming one of the most disabling consequences of the injury. These are known as post-traumatic headaches. The International Headache Society[1] recognizes post-traumatic headaches as a distinct category of headache disorder.
Unlike migraines or tension headaches that arise independently, a post-traumatic headache is classified as a secondary headache. It develops as a consequence of a brain injury. It may resemble a migraine or tension headache, but its relationship to the trauma is what distinguishes it. When these headaches continue beyond three months, they are classified as persistent post-traumatic headaches.[2]
Post-traumatic headaches can take many forms. Some people experience constant pressure or throbbing pain, while others suffer recurring episodes accompanied by nausea, dizziness, sensitivity to sound, or photophobia [3]—an abnormal sensitivity to light. Bright lights, computer screens, reading, and demanding mental activities may aggravate symptoms, making ordinary work and daily activities exhausting.
Why do these headaches sometimes become persistent? Neuroscience has not yet established a single explanation. Researchers believe several mechanisms may contribute, including neuroinflammation, altered pain-signaling pathways, changes in brain chemistry, and disturbances involving the neck and surrounding nerves. The interaction of these processes can make post-traumatic headaches particularly difficult to treat.[4]
Early recognition and appropriate medical management are important.
Early recognition and appropriate medical management are important. Treatment may include medications, physical therapy, management of associated neck injuries, and carefully paced physical and cognitive activity. Prolonged complete rest is generally discouraged; instead, patients should gradually resume activities as tolerated under appropriate medical guidance.
For individuals with persistent, disabling headaches, specialists may consider preventive medications, targeted nerve blocks, or Botox injections. Botox treatment for chronic migraine typically involves injections at 31 specific sites around the head and neck. These are therapeutic injections, not cosmetic treatments, and their use for post-traumatic headache requires individualized medical assessment. [5]
At Charlie Waters Law, we understand that a persistent post-traumatic headache is much more than an ordinary headache. We work with neurologists, headache specialists, physiatrists, and pain management physicians to understand the diagnosis, treatment needs, and consequences of these injuries. We know how to document the pain, the disruption to daily life, and the potential need for continuing medical care.
A headache that begins with a concussion should never be dismissed simply because the original injury was called “mild.” These headaches can be very serious and disabling.
Stay safe out there!
By Charlie Waters
Dallas Brain Injury Lawyer
Sources:
- Headache: The Journal of Head and Face Pain, https://americanheadachesociety.org/about, accessed 2026.
- National Institute of Neurological Disorders and Stroke, https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury-tbi#toc-how-does-tbi-affect-the-brain, 2026.
- Abusamak M, Alrawashdeh HM. Post-concussion Syndrome Light Sensitivity: A Case Report and Review of the Literature. Neuroophthalmology. 2021 Oct 13;46(2):85-90. doi: 10.1080/01658107.2021.1983612. PMID: 35273410; PMCID: PMC8903744.
- Mayer, C.L., Huber, B.R. and Peskind, E. (2013), Traumatic Brain Injury, Neuroinflammation, and Post-Traumatic Headaches. Headache: The Journal of Head and Face Pain, 53: 1523-1530. https://doi.org/10.1111/head.12173
- Seymour Solomon. MD, https://www.brainline.org/topic/headaches, Brainline, reviewed August, 2018.
