During a recent episode of the Migraine Again Podcast, hosted by Paula Dumas, Carrie in Oklahoma asks about how she should treat post-traumatic headaches:

Do you have any recommendations for migraines caused by brain trauma? Mine are worse due to storms and weather changes, but they didn’t appear until roughly two years after a severe head injury. I have five metal plates in my frontal bone, and I’ve tried many different things, and they all just put me on an emotional roller coaster. I do have concussion syndrome and TBI, which play a big role in my issues. Any suggestions or thoughts on that?

Paula K. Dumas: Yeah, just a few. Carrie, first I’m so sorry, it sounds like a really rough pain cycle that you are going through. And I can relate because I had a few concussions myself, two really bad ones that played a role in my migraine as well. Many people with migraine have had more than their share of concussions and TBI’s, and so your smart to have connected the two.

A lot of people ask about the weather, and rather than address that in this time, I would encourage you to listen to our program with CBS / Weather Channel meteorologist Alexandra Steele for more insights on why weather triggers attacks.

First I have to give you a disclaimer, I’m not a doctor and if you ask a medical question I can’t answer it specifically. But what I can do is share with you what the research says, and what other people in our community report, but I can’t give any personalized medical advice. Only your doctor can do that.

That said, most people underestimate their concussion history. Even if you think you’ve had two, three, or four, you’ve probably had double or triple that because of how concussion is now defined. A concussion occurs when the head is hit in some way by a strong force, it can happen a lot in car accidents, falls, stumbles, sports is huge, military service is huge. And concussions are just the most common form of a TBI or traumatic brain injury.

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It’s becoming a really significant issue in the NFL, we talked with Terrell Davis about his concussion history, and he was kind of putting two and two together there. One in five combat veterans also have migraine, and that is way above the national average, so you know that there’s some link going on.

Now concussions are often a triggering event in somebody who has a genetic predisposition to migraine, and doctors regard migraine as a neurological disease. So it’s not necessarily the concussion that’s causing the migraine, but rather than triggers the onset of it. And the onset of frequent headaches and depression can also be traced to even a mild TBI, so it’s worth doing a good health history.

3 Things You Need to Know About How to Treat Post-traumatic Headaches and Migraines

1 – Get tested promptly and treated immediately. The most effective way to control a concussion-related migraine is to seek medical attention right after any kind of head trauma. And there are medical tests that can positively diagnose even the most minor TBI, you see them doing them on the sidelines, and paramedics doing these tests. That allows you to get the prompt, proper medical treatment that can control or eliminate the painful symptoms while allowing the brain to heal.

As a mom of a very active son, we went through this recently. He had his third concussion in two years from flag football, and I said: “I think you’re going to be benched now.” Sometimes you have to go to that because untreated TBI can lead to memory problems, relationship failures, work issues, personality changes even, PTSD, and continued health issues, it’s serious business.

2 – Watch out for repeated concussions. You’re more likely to develop further concussions after you’re suffered the first one, which is kind of fascinating, is if we’re predisposed.

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And there are medical tests, as we talk about, to diagnose and get that prompt treatment to eliminate the symptoms. But you really need to watch out for the repeated concussions, which brings us to the third point.

3 – Prevent, prevent, prevent. You’re actually at greater risk after your first concussion. During the 2018 Migraine World Summit, Dr. Joel Saper from the Michigan Headache and Neurological Institute, warned: “Migraine itself leads to more concussions, meaning you’re more at risk for a concussion because you have a migraine vulnerability.”

Bubble wrap might seem tempting, but it’s not necessary. Helmets, really smart move. You don’t have to wear them when you take a bath, but don’t even think of getting on a horse, a bike or a scooter without one. A change of sport or career may also be smart if you’ve had more than one concussion, or like my son, you’ve played too much flag football and need to be benched. What it really comes down to is the life that you want to live after your injury.

Once you have recurring migraine episodes in your life, the approach is the same as somebody who hasn’t had any concussions at all. The way you manage them is not going to change. At that point, you’re focused on how to treat post-traumatic headaches and migraines, and not the concussion.

 

 


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