Common Stressors

Concussion and post-traumatic headache

How head injury and migraine interact, and why prior migraine can slow recovery.

4 min read · 5 research sources · Based on the Mastering Migraine courses by Dr. Adam Harcourt

Three common outcomes with migraine after a concussion.

Headache is the most common symptom after a concussion, and it often looks just like migraine ¹.

The two-way relationship

Concussion can bring on migraine-like headache in people who never had it before, or make existing migraine worse ^1,2.
Pre-existing migraine is associated with more symptoms and longer recovery after concussion ³.
Post-traumatic headache involves changes in autonomic function similar to migraine ⁴.

Sports and head injury

Migraine and other headache disorders are closely tied to sports-related concussion, and pre-injury migraine can delay return to school and sports ^2,3.

How it is evaluated

Concussion often affects the eyes and balance system. The Vestibular/Ocular Motor Screening (VOMS) is one tool used to check for these problems after concussion ⁵. Dr. Harcourt’s exam includes eye movement, vestibular and balance testing.

Treating them together

Because concussion and migraine share mechanisms, Dr. Harcourt addresses them together, with an emphasis on neurological rehabilitation. Any significant head injury with severe headache, vomiting, confusion or weakness needs emergency care first.

This article is educational and does not replace a personal evaluation. Talk with your clinician before making changes to medications, supplements or diet.

Research cited on this page

Kamins J, Charles A. Posttraumatic Headache: Basic Mechanisms and Therapeutic Targets. Headache. 2018;58(6):811-826. PubMed 29757458 · DOI
Seifert T. The relationship of migraine and other headache disorders to concussion. Handb Clin Neurol. 2018;158:119-126. PubMed 30482339 · DOI
Terry DP, Huebschmann NA, Maxwell BA, et al. Preinjury Migraine History as a Risk Factor for Prolonged Return to School and Sports following Concussion. J Neurotrauma. 2019;36(1):142-151. PubMed 29732944 · DOI
Howard L, Dumkrieger G, Chong CD, et al. Symptoms of Autonomic Dysfunction Among Those With Persistent Posttraumatic Headache Attributed to Mild Traumatic Brain Injury: A Comparison to Migraine and Healthy Controls. Headache. 2018;58(9):1397-1407. PubMed 30156267 · DOI
Mucha A, Collins MW, Elbin RJ, et al. A Brief Vestibular/Ocular Motor Screening (VOMS) assessment to evaluate concussions: preliminary findings. Am J Sports Med. 2014;42(10):2479-86. PubMed 25106780 · DOI

Mastering Migraine is an educational resource and is not a substitute for individualized medical care. Always talk with your own doctor before changing medications, starting supplements, or beginning a new treatment.