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Chronic Post Traumatic Headache In Children


What is a chronic post-traumatic headache (CPTH)?

A CPTH develops days to weeks after a head injury and lasts longer than 3 months. A CPTH can also be a symptom of a more serious condition called post-concussion syndrome (PCS). PCS is a group of symptoms that affect your child's nerves, thinking, and behavior.

What increases my child's risk for a CPTH?

  • Being male
  • A past concussion
  • A history of headaches before the injury, especially if your child had migraines

What are the signs and symptoms of a CPTH?

Signs and symptoms depend on where your child was injured:

  • Mild to severe headaches that affect both sides of your child's head and may pulsate
  • Pain that happens almost every day or is worse with activity
  • Neck pain
  • Nausea or vomiting
  • Depression or anxiety
  • Trouble concentrating or remembering things
  • Poor school performance, such as lower grades than before the injury
  • Being sensitive to light or noise
  • Dizziness, trouble sleeping, or fatigue

How is a CPTH diagnosed?

Your child's healthcare provider will ask questions about your child's headache. Tell him about your child's head injury and if he lost consciousness after the injury. He may also ask if your child had any memory loss from the injury. Tell him where your child feels the pain, how severe it is, and how long it lasts. Tell him if anything helps or makes the pain worse. Your child may need any of the following:

  • A neurologic exam will show how well your child's brain works. Your child's healthcare provider will check how your child's pupils react to light. He may check your child's memory, hand grasp, and balance.
  • A CT or MRI may show the cause of your child's headaches. Your child may be given contrast liquid to help his or her brain show up better in the pictures. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his or her body.

How is a CPTH treated?

  • Pain medicines can help prevent or treat headache pain. Headache pain is easier to control if your child takes pain medicine as soon as he starts to feel pain. You will need to limit pain medicines to prevent a condition called rebound headaches. Your child's healthcare provider will tell you when and how often to give pain medicine. Your child may need any of the following:
    • Prescription pain medicines may be given to control or prevent headache pain. Your healthcare provider will tell you which medicines may work for your child.
    • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
    • Acetaminophen decreases pain. Acetaminophen is available without a doctor's order. Ask how much to give and how often to give it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
  • Medicines may be given to control nausea or vomiting.

What can I do to manage my child's symptoms?

  • Keep a headache record. Include when they start and stop and what made them better. Describe your child's symptoms, such as how the pain feels, where it is, and how bad it is. Record anything he ate or drank for the past 24 hours before the headache. Bring this to follow-up visits.
  • Apply heat or ice as directed. Heat and ice help decrease headache pain, and heat can also relieve muscle spasms. Cover the heat or ice pack with a towel before you place it on your child's skin. Apply heat on the area for 20 to 30 minutes every 2 hours for as many days as directed. Apply ice for 15 to 20 every hour or as directed. Your child's healthcare provider may recommend that you alternate heat and ice.
  • Have your child drink liquids as directed. Your child may need to drink more liquid to prevent dehydration. Dehydration can cause a headache. Ask your child's healthcare provider how much liquid your child needs to drink each day and which liquids are best for him.
  • Set a regular sleep schedule. A lack of sleep can trigger headaches or make them worse. Have your child go to bed and wake up at the same times each day. Talk to his healthcare provider about any problems with sleeping.
  • Talk to officials at your child's school. This will help them understand how to help your child. Your child may have attention or memory problems that he did not have before the headache began. He may need extra help to finish his homework or exams.
  • Offer your child a variety of healthy foods. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Do not give your child foods that trigger his headaches.
  • Have your child exercise regularly. Exercise helps decrease stress and headaches. Ask about the best exercise plan for your child. Ask if it is safe for your child to play sports. He may not be able to play contact sports, such as football, until he does not have symptoms. He will need to wear proper sports equipment to help prevent another concussion.
  • Do not let your adolescent smoke. Nicotine and other chemicals in cigarettes and cigars can trigger a headache and also cause lung damage. Ask your adolescent's healthcare provider for information if he currently smokes and needs help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before your adolescent uses these products.

Where can I find more information?

  • Brain Injury Association
    1608 Spring Hill Road
    Vienna , VA 22182
    Phone: 1- 703 - 761-0750
    Phone: 1- 800 - 444-6443
    Web Address:

Call 911 for any of the following:

  • You cannot wake your child.
  • Your child has a seizure.

When should I seek immediate care?

  • Your child has a sudden headache that seems different or much worse than his usual headaches.
  • Your child has sudden vision changes.

When should I contact my child's healthcare provider?

  • Your child has headaches more often, or his pain is more severe.
  • Your child has pain that starts when he strains or changes positions.
  • Your child has headaches that wake him during the night.
  • Your child has pain that is not helped with pain medicines.
  • Your child always has pain on the same side of his head.
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.