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Traumatic Brain Injury & Migraine

Every year close to 1.7 million Americans suffer a traumatic brain injury (TBI). Most people will recover after a few days of rest and return to their normal activities without any residual effects. Others will have a long, arduous road to recovery due to the extent of their trauma and may have lingering problems for years to come.

Then there are those with TBI who can experience lasting headaches and/or Migraine, the most common symptom, in addition to dizziness, fatigue and cognitive issues. Treating these tends to be a challenging for patient and doctor due to the persistent nature of these symptoms.

After a TBI, when a person is experiencing increased head pain, nausea and/or vomiting, feeling excessively sleepy, has weak limbs and/or seizures, and is having trouble speaking during a headache, an urgent visit to the doctor is warranted. The immediate care after a TBI is allowing the brain to rest, taking care not to over stimulate it. In addition to rest, additional treatments used to reduce head pain or Migraine attacks are extremely individualized. Modifications to a patient’s lifestyle include:

  • Steering clear of heavy activities
  • Staying away from things that require prolonged mental activity – computer work, texting, video games
  • Staying hydrated
  • If you have trouble remembering things, use a journal, calendar or app to help you stay on track
  • Maintain a proper sleep schedule
  • Do not skip meals
  • Limit caffeine or no caffeine
  • Avoid any foods that may trigger a Migraine attack
  • Use cold packs or heat on neck and or head
  • Staying away from alcohol is imperative
  • Acetaminophen for headache – not to be taken more than two to three days a week. This will help reduce the risk of medication overuse headache

In addition to lifestyle changes, complementary therapies such as physical therapy, massage, biofeedback, acupuncture, and meditation are often employed while trying to reduce head pain. Seeing a therapist is another treatment patients can utilize. Therapists trained in disease management or chronic pain may prove helpful to a TBI patient. These therapists can teach coping skills that may help them manage their head pain. Many of these alternative therapies are used in combination with traditional medicine.

Prescription medications are also used to treat headache and Migraine after a TBI. There are quite a few medications used off-label for Migraine and headache prevention. Here is a small sample:

  • Anti seizure medications – Topamax, Zonegran, Lamictal.
  • Anti-depressants – Elavil, Pamelor, Wellbutrin, Cymbalta.
  • Beta-blockers – Inderal and Blocadren (both FDA approved for Migraine prevention), Toprol, Lopressor
  • Calcium channel blockers – Norvasc, Cardizem, Calan aka verapmil.
  • Muscle relaxers – Skelaxin, Zanaflex
  • Carbonic anhydrase inhibitor – Neptazane, Diamox

Dietary Supplements can be useful, but patients should check with their doctor before starting any new dietary supplement or herb. According to the FDA “…some supplements pose health risks. They may contain harmful ingredients or be improperly manufactured or handled. Some of the supplements that have been used in Migraine and head pain include:

The most important part of TBI recovery is making sure the brain has time to heal. This means it must have plenty of rest and be symptom free before resuming normal activity. By pushing ourselves too hard during the recovery process, not only will this set back our improvement, but it will also delay the healing process.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • DrPseudo
    3 years ago

    I had a series of 3 head injuries within about a year. The most predominate was the one the Dr. said I had 15 broken bones in my head and a broken nose. I have had these Migraines for about 3-4 years now.They tried everything and I am now on; Fentanyl 50mcg/hr patches every 3 days (72 hrs), Norco 10-325 Mgs 4x a day and Clonazepam 2Mg 2x a day for seizers and Panic attacks. This has helped so I am able to get up and eat and on Better Days I even get some badly needed work around the house done.I still have Bad Days but not as bad as before I was put on these dosages. I have a very high tolerance to pain meds and pain as I was told at the hospital by medical staff when I was on Dilodid.I was able to eat and felt pretty fair in the hospital. I am able to do my daily chores like eat and clean up and not usually much more. When I first put on the Fentanyl Patch for the first 2 days feel pretty fair and am able to get out to the store and get some work done. I am on a disability for my back but have Migraines all day every day. I feel if I was on the 100 mcg/hr patch I would be able to work like I was in my mid 30’s now I am 55 years old. I was put in prison for something I did not do and I have been getting evidence since I got out. I got No Medical attention while in DOC custody.I Need help to pursue this as I am able to do what I am able to live life day to day.I want to stay with my Dr. and Not a Pain Clinic as they say they want to try an operation with a battery and wires running up to some kind of simulators and remote for pain control.I have No problem with the meds I am on and I Do Not get High on them but before I got to this point I had Many thoughts of Suicide due to Major Loss of Quality of life.My house is like camping out. I have not had gas heat or working plumbing for the last 17 months now.I don’t want to have the surgery because I do get relief from the meds I am on Now… I do feel I would do better with the higher dose patch. I am one that does not even like to take aspirin or anything unless absolutely necessary…

  • Carla Dul
    7 years ago

    I have had migrianes all of my life. however up until the past 6 yrs or so ago they were far and few between. over the past 6 yrs they have become increasingly frequent and harder to deal with. Recently I was diagnosed with Chronic Regional Pain Syndrome which my Dr. says is due to a series of accidents that I suffered. Now the Dr.s are offering me more aggressive treatment options. And I’m hoping that altho I know my migraines will never completely go away that they will once again become farther and fewer between.

  • Sherry Pitts
    7 years ago

    Traumatic brain injury & migraines: interesting & helpful.

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