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What Causes Chronic Daily Headache After Multiple Head Injuries?
Question: Several concussions over last 3 years. CT and MRI in 1st year were clear. have hit my head several times since. constant headaches, mostly severe, mood problems and swings. GP gave amitriptyline weakest dose before bed for past year. does not help. I have been legally blind since birth. I am not doing well at all.
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I am sorry about the situation that you are in.
Now I am assuming that your repeated concussions are related to accidents due the blindness and not due to loss of consciousness, please tell me if I am wrong as loss of consciousness would have different implications.
Also I am assuming that headaches have been present already at the time of your MRI. If they appeared later then another MRI would be recommended.
Now regarding management. You seem to have developed what are called chronic daily headaches, headache for at least 15 days a month. Regarding non pharmacological management since these headaches are often influenced by stress and anxiety relaxation techniques can be of help. Some sessions of physical therapy can help in relaxation of your neck muscles especially if you have neck pain as well, common in people with trauma injury episodes.
When it comes to medication amitriptyline was a valid first choice to start with, I agree with your GP in trying it as it is a first line treatment both for prevention of headaches as well as mood issues.
Since you have been taking it for a year which is an adequate trial and it has been ineffective other options should be tried. The other first line option for prevention of chronic headache and also commonly used as mood stabilizers are anticonvulsants. Most commonly used options which could be tried include topiramate, valproic acid or gabapentin.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and I am sorry about the situation that you are in.
Now I am assuming that your repeated concussions are related to accidents due the blindness and not due to loss of consciousness, please tell me if I am wrong as loss of consciousness would have different implications.
Also I am assuming that headaches have been present already at the time of your MRI. If they appeared later then another MRI would be recommended.
Now regarding management. You seem to have developed what are called chronic daily headaches, headache for at least 15 days a month. Regarding non pharmacological management since these headaches are often influenced by stress and anxiety relaxation techniques can be of help. Some sessions of physical therapy can help in relaxation of your neck muscles especially if you have neck pain as well, common in people with trauma injury episodes.
When it comes to medication amitriptyline was a valid first choice to start with, I agree with your GP in trying it as it is a first line treatment both for prevention of headaches as well as mood issues.
Since you have been taking it for a year which is an adequate trial and it has been ineffective other options should be tried. The other first line option for prevention of chronic headache and also commonly used as mood stabilizers are anticonvulsants. Most commonly used options which could be tried include topiramate, valproic acid or gabapentin.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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