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Chronic Headache & Auto Accidents

  I was in a high-speed rollover accident 15 months ago, and have had daily headaches since.  I didn't lose consciousness;  I was treated by a chiropractor and assessed by a neurologist.  Both tell me I will either have the headaches for one to two years, or I will have them for the rest of my life.  They have ruled out tension headaches, and have done xrays but nothing more.  They tell me there is nothing they or I can do to help.  The only medication that helps is Imetrex, taken only when the headaches become severe.  
  The vehicle I was riding in was packed full of bags, chairs, umbrellas, etc., and many of these items struck me in the head and arms.  Do you have any information about this type of chronic headache, and any opinion on my treatment thus far?  Thanks.
Dear Lauren:
Even relatively minor head injury like yours can cause what is termed the post-concussive or post-traumatic syndrome. The features include fatigue, loss of concentration, ill-defined dizziness, and headaches that resemble tension-type headaches. The majority of individuals recover form this syndrome in 2-3 months. The minority who do not take more than 1-2 years to recover, or may not recover completely at all.
Treatment of the headaches in this situation can be quite difficult. Multiple strategies may need to be used. In addition to the periodic use of a migraine-abortive agent such as imitrex, chronic use of tricyclic agents such as nortryptiline or amitryptiline may help. Non-pharmacological means such as psychotherapy, exercising, physical therapy, and biofeedback are also very beneficial.
An extensive neurological work-up is not indicated usually.
Good luck!

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