I still get headaches, albeit now mild and less often, after 16 years from my hemorrhagic stroke. So I ask you, is that normal? Time for research!
Headaches are very common after both stroke and traumatic brain injury (TBI), but the kind, timing, and severity can vary widely depending on the type of injury.
Typical Post-Brain-Injury Headaches
- Dull or nagging pain, often like migraines or tension headaches
- Might improve with hydration, sleep, or gentle massage and/or medication
- Moderate intensity, not escalating rapidly
- Pain triggered by stress, fatigue, or sensory overwhelming
- Neck-related pain (cervicogenic headaches) that gets worse with movement
Scheduled headaches
- Might begin immediately after injury or develop days, weeks, months or, in my case, years later.
- Can feel endless or just occasional, sometimes lasting days, weeks, months, or years later.
A “normal” post-brain-injury headache is one that
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Come with no new neurological symptoms
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Feels familiar in pattern, severity, and location for you where one applies pressure
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Gradually improves with your usual relief methods like rest, quiet, medications
Let’s get more specific:
Headaches After Stroke
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Statistically speaking, post-stroke headaches affect roughly 20-60% of stroke survivors.
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Like hemorrhagic stroke or subarachnoid hemorrhage, certain types can cause sudden, severe headaches during the stroke.
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Medication side effects, like blood thinners or other stroke meds, can contribute to headache symptoms. https://www.stroke.org.uk/stroke/effects/physical/pain-and-headaches
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The frequency can vary significantly with some people experiencing headaches during the acute phase, while others develop them during recovery.
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The location and type often depend on which region of the brain was affected by the stroke.
- Ischemic stroke headaches are less common but may occur due to brain tissue damage or secondary effects
Headaches After TBI
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Statistically speaking, post-traumatic headaches (PTH) occur in about 30-90% of people, depending on the severity of the injury.
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They can develop immediately or emerge weeks to months later.
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These headaches often have characteristics similar to tension headaches or migraines, and may be accompanied by sensitivity to light and sound, dizziness, or cognitive difficulties.
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Post-traumatic headaches often tension-type or migraine-like, triggered by brain tissue injury, swelling, or nerve irritation.
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Neck or jaw-related, like whiplash, muscle strain, or TMJ problems, after the injury can refer pain to the head.
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Chronic daily headaches – some people have ongoing pain for months or years due to changes in brain pain-processing pathways. https://pmc.ncbi.nlm.nih.gov/articles/PMC4062350/
Management Tips
- Stay hydrated and avoid triggers like caffeine withdrawal or skipped meals.
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Certain types, like hemorrhagic stroke or subarachnoid hemorrhage, can cause sudden, severe headaches during the stroke.
- Track headache patterns in a journal to identify trends.
- Consult a neurologist for special treatment, especially if headaches go on and interfere with recovery.
- Pain processing changes in the damaged brain areas can amplify pain signals.
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Lower tolerance for sensory input, like light, sound, or busy environments can trigger headaches more easily.
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Neck/shoulder tension are common with weakness, spasticity, or one-sided movement patterns after stroke or TBI.
- Use gentle therapies like quiet environments, cold packs, and relaxation techniques.
Why they occur:
- Direct tissue damage and inflammation
- Changes in blood flow and pressure
- Disruption of pain processing pathways
- Revision in blood vessels or nerve issues like missed regulation of signals, or misfiring can play a significant role.
- Muscle tension from stress, altered posture, or compensation patterns
- Medication side effects
- Sleep disturbances
- Emotional stress from adjusting to life changes
Headaches can significantly impact recovery and quality of life, affecting concentration, sleep, mood, and rehabilitation. However, they’re often treatable with appropriate medical management.
The pattern and timing of post-injury headaches are important clues to diagnose correctly, so keeping a diary of duration can be very helpful for healthcare providers in developing a treatment plan.
A “warning sign” headache is one that’s different in any important ways, like intensity, location, timing, or accompanying symptoms, should be checked out immediately if the headache is accompanied by any of the following:
- Sudden, severe headache (“worst headache of your life”)
- Worsening pain over time, especially if it doesn’t respond to usual treatments
- Repeated vomiting
- Unusual behavior or agitation
- Inconsolable crying or refusal to eat in children and adults
- Slurred speech or confusion
- Facial drooping, weakness, numbness, or loss of coordination
- Seizures or convulsions
- One pupil larger than the other
- Could point to swelling, fluid buildup, or infections
- Headache with fever, neck stiffness, or rash which can indicate meningitis or another serious infection
- Headache after a new injury or fall, even if mild at first
- Extreme drowsiness, fainting, or difficulty waking up
As an unknown brain-damaged person wrote, “I forget what it feels like to be headache free.”
I forget, too.
My TBI was on April 18, 1981, five days after my 21st birthday. In coma for a week, and in hospital for additional week. Doctor’s told family members I did not need any rehab. Surgery was to remove bone fragments from right frontal lobe, as well as forehead bone. Most, if not all, of right frontal lobe was removed. Lost all sight in right eye. Back to work after 12 weeks. The following August I went back into surgery to have plastic plate put in to cover the hole left from removal of bone on right forehead. In hospital for week, and out of work for additional week. From the point when I woke after surgery until this day I have suffered very painful headaches. Yes, 44 years of pain, so far. I’ve seen medical professionals in five states over the years. The only medication that will stop the pain from worsening (never goes away completely) is Fioricet #3 w/COD (an opiate). I have sensitivity to the usual triggers and head pain contributes to the memory, memory recall, concentration issues common to severe TBI. Thank you for keeping the blog.
Forty-four years of pain and no plan for the future except more meds? My very best wishes on your recovery if at all.