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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Headache After Head Injury

I got hit in the head hard with a pillow while my head was resting on the arm of a sofa. Immediately my head was hurting but passed quickly. The next day when I would lay down I got a massive headache where I would have to sit up for the pain to reduce. After that my head hurt constantly no matter if I was sitting up or not and it was hard to fall asleep. Now the pain starts as soon as I wake up till I fall asleep. Any answers ?
Mon, 9 Nov 2015
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Neurologist 's  Response
I read your question carefully and I understand your concern.

The kind of trauma you describe generally would seem not dangerous, not enough to cause any brain injuries. Even if there was such injury usually bleeding or swelling in the brain causes raised pressure in the skull, while that type of headache you describe on standing up is typical for low intracranial pressure. So it is hard to make a direct relationship between the injury and the headache.
However since it is a recent onset headache with features of low intracranial pressure it must be investigated. Blood pressure measurements supine and sitting are necessary to check for drop of blood pressure. Brain imaging with preferably MRI is necessary to look for causes of low intracranial pressure and if the findings are still suggestive of that a lumbar puncture as well.
In the meanwhile usual analgesics like paracetamol and drinking plenty of fluids are recommended.

I hope to have been of help.
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Suggest Treatment For Headache After Head Injury

I read your question carefully and I understand your concern. The kind of trauma you describe generally would seem not dangerous, not enough to cause any brain injuries. Even if there was such injury usually bleeding or swelling in the brain causes raised pressure in the skull, while that type of headache you describe on standing up is typical for low intracranial pressure. So it is hard to make a direct relationship between the injury and the headache. However since it is a recent onset headache with features of low intracranial pressure it must be investigated. Blood pressure measurements supine and sitting are necessary to check for drop of blood pressure. Brain imaging with preferably MRI is necessary to look for causes of low intracranial pressure and if the findings are still suggestive of that a lumbar puncture as well. In the meanwhile usual analgesics like paracetamol and drinking plenty of fluids are recommended. I hope to have been of help.