Headache, Posttraumatic

Key Features

• A variety of nonspecific symptoms may follow closed head injury, regardless of whether consciousness is lost

Clinical Findings

• Onset and course of headache

  • Usually appears within a day or so following injury

  • May worsen over the ensuing weeks

  • Gradually subsides

• Duration of symptoms

  • Relates in part to the severity of the original injury

  • However, even mild injuries may be followed by symptoms that persist for months

• Usually a constant dull ache, with superimposed throbbing that may be localized, lateralized, or generalized

• Sometimes accompanied by nausea, vomiting, or scintillating scotomas

Diagnosis

• Special investigations are usually not helpful

• Electroencephalogram may show minor nonspecific changes

• Electronystagmogram sometimes suggests either peripheral or central vestibulopathy

• CT scans or MRI of the head usually are normal

Treatment

• Headaches often respond to simple analgesics

• Severe headaches may necessitate preventive treatment as outlined for migraine