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Post-traumatic headaches can affect children differently but most headaches would be classified as chronic tension-type headaches. These headaches are often a steady ache on both sides of the head, occurring daily or almost every day.

They have mild to moderate headaches regularly, but occasionally they experience more severe headaches on top of these. These severe headaches are often similar to, if not identical with, a migraine (one sided throbbing pain associated with nausea and sensitivity to light and noise).

Children who experience post-traumatic headaches also experience other symptoms of the post- traumatic or post-concussion syndrome. These may include other neurological symptoms like dizziness, ringing in the ears, vague blurring of vision, psychological symptoms such as depression, anxiety, personality change and disturbance in sleep.

Children with post-concussion syndrome have changes in their mental functioning. This presents as difficulty with concentration, inability to work efficiently and associated difficulty maintaining attention and retaining memory.

Your concussion needs to be treated by your general practitioner to make sure that you get the best care for recovery. Immediately following concussion, you should “rest.� This means no significant exercise, no texting, no driving, no video games, and limited school work, for at least a few days until symptoms improve.

In the first few weeks following concussion, any activities that make your headaches or other post-concussion symptoms worse, should be limited. 

Once headaches and other symptoms are gone, you may gradually increase your activity using the Concussion Action Plan (CAP) step/zone-wise plan recommended by your general practitioner. 

However, if headaches or other symptoms return with activity, then you need to return to the prior, lower level of activity. 

There is a concern that long periods of complete rest may eventually worsen rather than help symptoms. Therefore in some instances where headaches persist a few weeks post-concussion, your general practitioner may direct you to begin low- impact aerobic exercise (“sub-threshold� exercise, such as walking, slow swimming, and slow stationary biking).

This is as long as it does not make your headache or other symptoms worse.

Paracetamol may be recommended for severe headaches in the few days following an injury. Once it is clear that there is no bleeding, ibuprofen can also be used to help reduce headache pain. Make sure that you take the dose that is recommended on the package for your age and weight.

Resting in a cool, dark, quiet place can lessen headaches and some people find that putting cold packs on the area that hurts can also help.

If you have headaches, that have characteristics of migraines, they should be treated with typical migraine medications. Other more specific medication may be prescribed to treat a severe migraine-type headache that doesn’t respond to ibuprofen or paracetamol for teenagers with a history of migraine headaches, or migraine type post-concussion headaches.

To manage these headaches it is also very important to:

• Drink plenty of water
• Get regular sleep
• Eat regular healthy meals
• Decrease or manage stress
• Avoid repeat head injury
• Eliminate nicotine and alcohol
• Practice relaxation techniques (e.g. meditation and deep breathing)
• Pain coping techniques (in conjunction with a psychologist)

This treatment plan, in addition to regular meals, good hydration, stress management, and regular sleep, may also include:

• Medications to treat “spikesâ€� in headache such as paracetamol or ibuprofen. Make sure that you take the dose that is recommended on the package for your age and weight.
• Daily supplements such as magnesium, omega-3 fatty acids, or riboflavin used to decrease headache frequency and severity.
• Daily prescribed preventive headache medications to decrease headache frequency and severity.
• Complementary therapies such as physical therapy, massage, biofeedback therapy, or acupuncture.

If you participate in sports, once the concussion symptoms are gone when resting, you need to follow a gradual step- wise approach to returning to athletic activity. This is outlined in the Concussion Action Plan (CAP).

If you have had multiple concussions, however, it is important to discuss the risks of future concussions with your general practitioner, and weigh the benefits of continuing a particular sport. 

If you have had past concussions, you are more likely to have one in the future, and the recovery time may be even longer after each subsequent concussion.