Q. I need some advice. Over four years ago, I was thrown from my car, despite wearing a seatbelt, and landed on my head. I have read that most post-concussive headaches resolve within weeks or months. I, however, have had a headache all day, every day since the wreck. I have tried countless medications and treatments with little to no relief. Do you have any suggestions?

A. Unfortunately, many people experience headaches following head trauma or concussion. Most do, in fact, resolve, but approximately 15 % of post-traumatic headaches become chronic. This means that the headache has persisted beyond three months, and the longer the headache continues, the less likely it is to resolve spontaneously. There are no specific treatments for post-traumatic headache. Generally treatment is based on the quality of the headaches and the type of symptoms associated with them. Frequently, when someone has had long-standing post-traumatic headache that has not responded well to treatment, it is appropriate to consider an inter-disciplinary headache program that emphasizes approaches that use medications, physical treatments and non-medical treatment, such as biofeedback. I think it would be valuable for you to discuss these options with your healthcare professional.

Roger K. Cady, MD
Director, Headache Care Center