Headaches, Traumatic Brain Injury, and Concussion

  • Jay Alberts
  • Neil Cherian


Concussion is considered a subset of traumatic brain injury (TBI) resulting in a transient disturbance in brain function, due to a direct or indirect blow to the head. Head-trauma-related symptoms are quite common and varied. Eighty to ninety percent of individuals recover neurologic function within 10 days of injury.

Headache is the most frequently reported symptom of sport-related concussion, and one of the most common symptoms requiring pharmacological management, with up to 86 % of athletes reporting posttraumatic headaches. It is estimated that 15 % of individuals will develop chronic posttraumatic headache as a result of mild head injury.

The most common recognizable forms of posttraumatic headache in concussion are tension-type headache, cervicogenic headache, migraine, and combined tension-type headache and migraine. The posttraumatic headache is thought to impair other functions such as energy, sleep, attention, higher-level cognitive function, and emotion. Headaches can also result in decreased activity tolerance and are frequently exacerbated during exercise. Physical activity tolerance testing is a component of return-to-play rehabilitation programs.

Once the headache type has been determined, treatment is often consistent with the respective disorder. Experts urge a cautious approach, an intense preventive and acute regimen of medicines treating immediate post-injury headache and other symptoms of concussion may mask unresolved symptoms and lead to the premature return of an athlete to the playing field or return a soldier to battle prematurely. In addition, the frequent use of acute medications can lead to medication overuse headache, complicating accurate evaluation of the patient‟s progress.


Concussion Posttraumatic headache Traumatic brain injury 

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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  1. 1.Concussion Center, Neurological InstituteCleveland ClinicClevelandUSA
  2. 2.Department of Biomedical Engineering, ND20Cleveland Clinic Lerner Research InstituteClevelandUSA
  3. 3.Headache Center, Neurological Center for Pain, Neurological InstituteCleveland ClinicClevelandUSA

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