From the Research
For post-concussion headaches, acetaminophen (Tylenol) is generally recommended as the first-line treatment at a dose of 500-1000mg every 6 hours, not exceeding 4000mg daily, as it does not increase bleeding risk, which is crucial after head injury 1. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) at 400-600mg every 6-8 hours can be used if acetaminophen isn't effective, but should be avoided in the first 24-48 hours after injury due to bleeding concerns.
Key Considerations
- The use of ibuprofen, acetaminophen, or both does not decrease the risk of headache at 7 days post-concussion, as shown in a study published in 2022 1.
- A national survey of abortive therapies used in the emergency department for pediatric post-concussion headaches found that treatment is highly variable, with metoclopramide, physiologic saline, and NSAIDs being commonly used 2.
- A pilot study from 2017 suggested that routine analgesia administration with acetaminophen, ibuprofen, or both may be feasible and effective for postconcussive headache management, but a larger full-scale randomized controlled trial is required to further assess efficacy 3.
Management Strategies
- Rest, adequate hydration, and avoiding screens, bright lights, and loud noises can help manage symptoms.
- If headaches worsen, are accompanied by vomiting, confusion, or weakness, seek immediate medical attention as this could indicate a more serious condition.
- Treatment should be individualized based on specific symptoms and medical history, so consulting with a healthcare provider is essential for persistent post-concussion headaches.