What is Post-Traumatic Headache (PTH)?

Facts about PTH

Approximately 25,000 people suffer a concussion annually. The vast majority recover completely within days or weeks. 

Approximately 20-30% develop a chronic headache (PTH) that lasts for more than 3 months. 

PTH affects more women than men and is seen more frequently in the younger and older segments of the population.

PTH cannot be diagnosed with blood tests and is rarely diagnosed via a scan, so the diagnosis is based on the description of symptoms that you provide.

In connection with a concussion, it is believed that temporary changes occur in the function and metabolism of brain cells, as well as in the brain's ability to process sensory input.

With chronic PTH, the prognosis is difficult to predict. For some, symptoms will subside over months or years, while others will experience persistent symptoms.

PTH can significantly affect quality of life.

Symptoms of PTH

• Most people with PTH develop symptoms similar to migraine or tension-type headache.
• The pain can therefore be experienced as a constant sensation of having a tight band around the head or as a pulsating, throbbing, or stabbing pain on both or just one side of the head.
• For some, the headache is constant; for others, it occurs in episodes of varying intensity and duration.
• The headache can be aggravated by physical activity.
• In addition to the headache, you may experience nausea and sensitivity to light and sound.
• You tire easily and have a high need for sleep.
• Many suffer from concentration and memory problems.
• You may experience emotional effects, typically sadness or irritability.

Treatment options for PTH

There is no medical treatment specifically targeted at PTH, but in some cases, medication for other types of headaches can reduce pain intensity and the frequency of attacks. 

Medical treatment is chosen based on the described headache symptoms and which diagnosis they most closely resemble, typically migraine or tension-type headache. Preventive medication can in some cases reduce the frequency and intensity of the pain.

If there is muscle soreness and/or tension around the neck or head, it may be relevant to be assessed by a physiotherapist for, for example, exercises or relaxation techniques.

It is often beneficial to have conversations and support to find tools for managing life with persistent headaches and to avoid medication-overuse headache (MOH), which can potentially worsen your symptoms.

Acute treatment 

• Triptans can be effective if the headache primarily resembles migraine attacks.
• Pain relievers such as paracetamol and ibuprofen can provide relief for pain that most closely resembles tension-type headaches.