Scientists at Copenhagen University Hospital compared 132 adults who still had headaches a year or more after a mild traumatic brain injury (called persistent post-traumatic headache, or PTH) with 751 people who have migraines. They collected details about pain features, disability scores, mood symptoms and the medicines people use day to day. The results were published in Cephalalgia, a journal of the International Headache Society.
The findings were:
Most PTH looks like migraine. A striking 94 percent of concussion sufferers met the formal criteria for migraine-type headache.
The frequency and comorbidities (accompanying conditions) are similar to chronic migraine. People with PTH averaged 27 headache days a month—virtually identical to chronic migraine—so their disability, anxiety and depression scores lined up with the chronic migraine population.
A few features still separate the two. Concussion headaches were more often felt on both sides of the head, caused slightly less nausea and vomiting, and were treated with everyday painkillers (acetaminophen or ibuprofen) more often than with migraine-specific drugs such as triptans.
Under-treatment is common. Fewer than 40 percent of PTH patients were using any preventive medication, even though their disability matched chronic migraine, hinting that many never receive aggressive migraine-style care.
Persistent post-traumatic headache is not “just a lingering headache.” It can be every bit as disabling as long-standing migraine—yet it often flies under the radar, leading to inadequate treatment and prolonged suffering. Recognizing its migraine-like nature means doctors can use proven migraine strategies (from triptans to Botox) instead of relying solely on simple pain relievers or “watch-and-wait.”
This was a study from a specialist clinic, so the participants may represent the more severe end of the spectrum, and self-reported questionnaires always leave room for recall errors.
Bottom line
If your post-concussion headaches sound and feel like migraines, you’re not imagining it—and you deserve the same level of care. Talk with a headache specialist about migraine-focused treatments and a comprehensive plan that also addresses mood issues and neck pain. The earlier PTH is treated like the serious, migraine-like disorder it often is, the quicker life can get back on track.
