At Shane Smith Law, we’re passionate about advocating for individuals dealing with the life-changing aftermath of brain injuries.
In a recent episode of our Mind Matters podcast, Legal Nurse Consultant Kiley Como sat down with Dr. Gilbert Mbeo of the Brain, Spine and Pain Institute to explore one of the most common yet often misunderstood symptoms of traumatic brain injury: post-traumatic headaches.
What Is a Post-Traumatic Headache?
Post-traumatic headaches (PTH) are a frequent complaint among individuals who have suffered a concussion or traumatic brain injury (TBI). As Dr. Mbeo explains, these headaches don’t come in a one-size-fits-all package. Instead, they present in multiple “phenotypes,” or styles—most commonly mimicking migraines or tension-type headaches.
Migraine-like headaches are often described as throbbing, one-sided, and sensitive to light (photophobia) and sound (phonophobia), sometimes preceded by visual disturbances known as an aura. Tension-type headaches, on the other hand, feel like a tight band around the head and worsen throughout the day, especially in stressful environments.
Understanding these phenotypes is crucial—not just for diagnosis but also for determining the most effective treatment.
For a free legal consultation, call (980) 246-2656
Acute vs. Persistent: How Long Do These Headaches Last?
PTH is typically classified in two ways:
- Acute Post–Traumatic Headaches begin within seven days of the injury and resolve within three months.
- Persistent Post–Traumatic Headaches last longer than three months and, in some cases, continue for years.
Dr. Mbeo notes that it’s not uncommon to see patients years after an injury still struggling with these persistent headaches, highlighting the long-term nature of concussion-related trauma.
Why Treatment Can Be So Challenging
One of the biggest hurdles in treating PTH is the lack of standardized treatment protocols. While migraines and other common headaches have long-established treatment paths, PTH remains a less-charted territory. This forces physicians to lean heavily on clinical expertise, patient history, and a trial-and-error approach.
Adding to the complexity is the high rate of comorbidities—co-occurring conditions like sleep disturbances, anxiety, depression, and cognitive difficulties.
These conditions don’t just complicate the clinical picture; they can actually worsen headache symptoms and impact how patients respond to medications.
For example, a medication like Topiramate, often used for migraines, may not be suitable for someone with cognitive challenges. Alternatively, drugs like Venlafaxine (Effexor) may be better choices for patients also struggling with anxiety or depression.
Click to contact our personal injury lawyers today
The Risk of Medication Overuse and Polypharmacy
Dr. Mbeo emphasizes the serious concerns surrounding polypharmacy—especially in older patients. Many patients with PTH may already be taking several medications for other conditions, leading to risks of drug interactions and side effects.
Another growing issue is medication overuse headaches, which often result from self-medicating with pain relievers like NSAIDs multiple times a day. Ironically, this can create a vicious cycle where the very medications meant to relieve pain actually prolong or worsen it.
The same applies to over-the-counter supplements, which are often forgotten during medication reviews but can alter metabolism, interact with prescription drugs, and even trigger headaches themselves.
Complete a Free Case Evaluation form now
The Gold Standard: A Personalized, Phenotype-Based Approach
According to Dr. Mbeo, the best approach to treating PTH is personalized care—matching the headache phenotype and patient history to the most appropriate interventions.
For acute PTH, early interventions might include NSAIDs and triptans (like sumatriptan), assuming no red flags are present. However, he cautions that all patients should be screened thoroughly for signs of more serious conditions, such as subdural hematomas or other intracranial bleeding.
Symptoms like drooping facial muscles, limb weakness, slurred speech, or confusion may indicate a medical emergency—not just a headache.
Know the Warning Signs—and When to Act
The final takeaway? Pay attention to red flags. If you or a loved one experiences a sudden, severe headache after a head injury—especially one accompanied by neurologic symptoms—call 911 immediately.
Post-traumatic headaches are complex, nuanced, and highly individualized. But with the right medical care and legal advocacy, those suffering can begin to reclaim their quality of life.
🎧 Catch the full conversation on the Mind Matters podcast and stay informed on cutting-edge brain injury topics. And if you or someone you love has suffered a head injury and need a brain injury lawyer, remember:
In pain? Call Shane!
📞 980-999-9999
Call or text (980) 246-2656 or complete a Free Case Evaluation form
