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PAIN AFTER A HEAD INJURY: PAIN IMMEDIATELY AFTER A HEAD INJURY

Firstly, there is the immediate post-injury headache, occurring during the first week after the accident. Secondly, there can be post-concussion headaches – which may be a concussion headache that doesn’t go away, or else a headache which comes on even as late as six months after the original injury.

Pain immediately after a head injury

A lot of things can happen from a blow to the head. Firstly, there’s local bruising to the skin, fat and muscles overlying the skull, each of which will cause pain. The bones of the skull may be bruised or broken, which is another source of pain. The brain may undergo a shearing force, pulling and stretching its nerve fibres; surprisingly, the brain hasn’t got any sensory pain fibres in it, so it can’t feel pain directly from this, but headaches often occur after concussion for other reasons. Bleeding into the skull raises the pressure inside the head, and this can cause an intense headache.

Any injury to the skull is likely also to injure the neck to some extent, and there may be pain from muscles and ligaments which have been over-stretched, joints that have been moved into abnormal positions, and bones that have been broken.

Obviously, not all of this happens in every head injury, but it does give an idea of the large number of different sources of pain that can follow after a single blow.

One of the most potent sources of pain after a head injury comes from the neck muscles. Often a simple head injury traumatises the neck sufficiently to cause all the muscles to go into spasm. This can occur after relatively minor blows; for example, on banging your head under a shelf.

Type of headache

The headache immediately after a head injury is usually throbbing, with tenderness locally at the site of the injury; it is frequently accompanied by a generalised headache, from spasm in the neck muscles.

Treatment

Treatment following head injury depends on exactly what injuries have been sustained; see the relevant section above for each type of injury.

*62\20\2*

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