post-traumatic headache syndrome

When is a headache not just a headache?

Most people experience mild to moderate headaches from time to time, and they’re usually a harmless nuisance. For people who’ve suffered a traumatic brain injury, on the other hand, headaches can become a chronic, demoralizing, and disabling affliction.

This problem is not only deadly and debilitating; it’s also expanding. Those numbers, from a 2014 survey by the Centers for Disease Control (CDC), show a 56% increase in TBIs since 2006.

Any significant impact to the head can cause a TBI, as can any violent jolting of the body that causes the brain to strike the inside of the skull, but the most common events leading to TBIs are falls (accounting for 48% of TBI hospitalizations) and vehicular accidents (accounting for 20%). Contact sports, assaults, and military combat are also frequent sources of TBIs.

While some of the effects of TBIs are immediately observable — loss of consciousness, vomiting, impaired cognition and coordination — other symptoms cannot be predicted or detected, and may continue troubling the patient for months, years, or even permanently. Of these frustratingly invisible and lingering symptoms, headaches are the most commonly reported.

Lack of observable evidence can be a serious problem for anyone who sustains a TBI as a result of someone else’s malice or negligence and must rely on a court ruling to cover the cost of treating or living with the symptoms. If you’re facing this uphill battle, the experts at The Stoddard Firm have the experience you’ll need on your side to get the compensation you deserve.

What Is Post-Traumatic Headache Syndrome?

Post-traumatic headache syndrome, or PTH, is defined as a headache developing within seven days of a TBI, or within seven days of regaining consciousness after a TBI. If the headache lasts longer than three months, which happens in 18% to 65% of cases, it is considered persistent post traumatic headache (PPTH), also known as chronic post-traumatic headache (CPTHA). Mild TBIs, commonly known as concussions, are just as likely to produce post-traumatic headaches as more damaging head injuries. In fact, there seems to be no correlation at all between the severity of the head injury and the severity of resulting PTH.

Most post-traumatic headaches mimic the symptoms of migraines, which may include:

• Moderate to severe pounding or piercing pain
• Sensitivity to light, sound, and movement
• Nausea
• Visual distortions

Other post-traumatic headaches take on the characteristics of tension or cervicogenic headaches, which are typically milder, duller, and more closely linked with muscle soreness or tightness in the head and neck area. Still others take the form of cluster headaches, which are more localized but intense enough to have earned the nickname “suicide headache” for their devastating effect on quality of life and mental health.

Patients with PTH often exhibit heightened sensitivity to stimuli involving the head and neck, even when not experiencing an active headache. Frequency of the headaches themselves can range from weekly episodes to constant, unrelenting pain.

Telling the Difference Between Post-Traumatic Headache Syndrome and Migraine

Although post-traumatic headaches and migraines share similar symptoms, and neither is yet fully understood by medical science, current research indicates that they are not the same thing on a neurological level.

One 2018 study found that headache patients who had suffered a TBI were significantly more likely to show symptoms of autonomic dysfunction than uninjured patients with comparable migraine symptoms. This supports the theory that PTH may be caused by a combination of swelling in important structures of the brain, whiplash injuries to the neck and spinal cord, and even damage to the pain processing centers of the brain itself.

The autonomic nervous system governs basic bodily functions that do not require conscious effort, such as heartbeat, breathing, and digestion. Autonomic dysfunction can take many forms, as there are many systems that can be affected, but some of the most common signs include:

• Dizziness/vertigo
• Excessive or inadequate sweating
• Lack of heartrate elevation with attempted exertion
• Difficulty swallowing
• Constipation, diarrhea, or other digestive disturbances
• Incontinence or difficulty urinating
• Sexual dysfunction
• Vision impairment, due to unresponsive pupils

While these additional symptoms of neurological damage are obviously burdensome to patients in their own right, they can be helpful in differentiating PTH from migraine headaches during diagnosis and treatment planning.

Risk Factors and Comorbidity

Even though post-traumatic headaches are not technically migraines, a personal or family history of migraines can increase a person’s risk of developing PTH following a traumatic brain injury. Like most neurological conditions, women and older individuals are more medically susceptible to PTH, but young males are also affected in large numbers, partly because they make up the majority of participants in careers and hobbies that carry an elevated risk of sustaining a TBI in the first place.

Two studies focusing on high school football players in Kentucky and Florida found that they were twice as likely as the general population to experience what they believed to be migraines. Even more concerning was the finding that many of the players had never sought treatment, out of fear of looking weak, failing to live up to expectations, or losing a place on a team.

The U.S military has also come to recognize chronic, trauma-related headaches as a major health issue among service members, comparable with post-traumatic stress disorder (PTSD). One study performed at the Uniformed Services University found that 54% of service members who suffered TBIs went on to experience migraine-like symptoms, and that they experienced them with much greater frequency than their uninjured counterparts with migraines.

Military personnel may be especially prone to developing PTH due to comorbidity between PTH and PTSD. Emotional disturbances such as PTSD, depression, and anxiety can trigger and exacerbate post-traumatic headaches, inhibiting neurological healing. Service members are of course exposed to notoriously traumatic circumstances, but this phenomenon can affect civilian patients as well. An act of violence, a car accident, or even a fall can sometimes result in PTSD.

Treatment and Prognosis

There is no standardized treatment for PTH, and once it proves persistent past three months, there’s no universal timeline for recovery. Many patients cannot work, attend school, or participate in their favorite activities for an extended period of time, leading to lost income, derailed ambitions, relationship challenges, and depression. However, with time, experimentation, a strong home support system, and the help of a team of healthcare professionals, most patients do eventually see improvement.

An effective, individualized treatment program will generally incorporate multiple therapeutic techniques and sometimes multiple medical disciplines. Key elements in a treatment strategy might include:

• Prescription medications, to ease pain and correct neurochemical imbalances
• Injections of Botox, steroids, or local anesthetics
• Lifestyle changes, to limit environmental and food-based irritants
• Physical therapy, to treat contributing neck injuries
• Psychiatric care, to address PTSD, depression, anxiety, and other emotional challenges that can result from or worsen PTH

Although finding an effective treatment or combination of treatments for PTH can be difficult and time-consuming, even with the help of qualified healthcare providers, it’s important not to give up or “go it alone.” Pressure to perform at a pre-injury level too soon can hinder the healing process, and excessive use of over-the-counter painkillers can lead to rebound headaches, making the problem worse. In order to maximize quality of life and ultimately restore productivity, PTH patients need time and professional assistance to figure out what works for them.

Pain Is One of the Hardest Things to Prove

Unfortunately for many people with PTH, recovery time and professional assistance can be prohibitively expensive. After being attacked, struck by a vehicle, tripped up by unsafe premises, injured by machinery at work, or otherwise subjected to a TBI as a result of someone else’s malice or negligence, a person’s ability to rest and seek treatment often depends on a court ruling.

Getting a fair settlement for PTH is especially difficult, because the condition is characterized almost entirely by pain, and there’s no test that can perfectly verify how much pain a person is in. PTH patients often find themselves struggling to make their own families and friends understand how real their symptoms are. Trying to convince strangers can be a daunting and harrowing task, especially with the negligent party’s legal team doing everything possible to cast doubt.

If the thought of trying to prove the existence of your PTH makes you feel nervous or embarrassed, remember to trust and respect your body. When you’re in pain, it’s real. When the pain interferes in your daily life, that’s real too. Others may try to make you feel like you’re imagining things, or making a big deal out of nothing for profit and attention, but PTH is just as real as a broken bone or lost limb and the lawyers at The Stoddard Firm believe it should be treated as such. In fact, the potential for a legal settlement has no statistical effect on the PTH symptoms that patients report, indicating that exaggerating the condition for profit is so rare as to be statistically insignificant.

Likewise, using the law to stand up for yourself when you’ve been hurt is not greed. Rather, it’s often the only way to combat the greed of those who skimp on safety and security measures and put the public at risk.

The Stoddard Firm Has Experience Representing Clients with Invisible Injuries

Winning compensation for PTH is a complex but worthwhile endeavor, and it’s crucial to have qualified legal counsel to help you through the process. The seasoned experts at The Stoddard Firm have experience presenting a wide range of personal injury cases, and we’ve successfully secured both verdicts and settlements for many clients with invisible injuries like post traumatic headaches.

We recognize the weight of what you’re going through, and we’ll take the time to learn the specifics of your condition and the injury that led to it. That way, we can explain it in court in an understandable, relatable manner, so you get the best settlement possible. Every step of the way, we’ll work to take the stress of legal proceedings off of your shoulders, so you can devote maximum energy to getting well.

In addition to our knowledge of how chronic invisible conditions affect patients’ lives, we’re experts in the fields of premises liability, negligent security, products liability, and vehicle accidents. If you’re not sure what type of case you have or whether we cover it, feel free to ask! We have experts standing by 24/7, ready to provide you with a free consultation on your unique situation. Reach out today at 678-RESULTS, or through our online chat function, to get started.