Post-traumatic Headache

Post-traumatic headaches (PTHAs) are a common occurrence following mild traumatic brain injury (mTBI), and while most PTHAs resolve, a proportion of patients develop chronic headache disorders. The exact mechanism(s) by which PTHAs develop are unknown, but herein we review some of the current pathophysiologic hypotheses. History and physical examination are important to rule out potentially dangerous secondary conditions, determine treatment approach, and evaluate for the need for further workup or neuroimaging. Treatment of PTHA requires phenotyping of the PTHA using criteria for primary headache disorders, as most PTHAs meet criteria for primary headache disorders and are usually migraine or tension-type headaches. The therapeutic approach to PTHA requires optimizing pharmacologic and non-pharmacologic management of each patient’s head and neck pain as well as treatment of associated comorbidities.