Concussion Headache and Migraine Specialists

Post-traumatic headache is the most common persistent symptom after a concussion, and it is not one condition. Migraine-type, tension-type, neck-driven (cervicogenic) and medication-overuse headaches each need different treatment, which is why sorting out which one you have matters more than the first prescription.

The reason two people with an identical-sounding concussion headache need completely different appointments is that the mechanism differs. A migraine-type headache after concussion responds to migraine management. A cervicogenic headache is coming from the neck and responds to manual therapy and exercise. A rebound headache is being maintained by the medication being used to treat it. Distinguishing them is an examination, not a questionnaire.

Medication after concussion is chosen to target a symptom and prescribed off-label; nothing is approved specifically for this indication. The NIH's neurological institute describes drug treatment after brain injury in exactly those terms — medicines selected by the symptom being managed, with no concussion-specific approved drug named. Pain relief buys function while something else does the actual work.

Before the appointment, do one unglamorous thing: count. Write down what you took and on which days for the past month, including anything bought over the counter, and bring that list. Someone quietly self-managing on drugstore analgesia for four months is presenting a very different problem than someone who took nothing, and only you can tell them which you are.