Factors Associated with Sport-Related Post-concussion Headache and Opportunities for Treatment

  • Johna K. Register-MihalikEmail author
  • Christina B. Vander Vegt
  • Michael Cools
  • Kevin Carnerio
Concussion and Head Injury (A Finkel, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Concussion and Head Injury


Purpose of Review

The purpose of this review is to (1) describe factors both pre- and post-injury that are associated with post-concussion headache, (2) describe the influence of post-concussion headache on recovery following concussion, and (3) provide potential post-concussion treatment options that may reduce the burden of headache, as well as other symptoms to facilitate recovery.

Recent Findings

Various factors may be associated with post-concussion headache presentation. These may include pre-injury or historical factors such as sex, family and self-history of headache and migraine, concussion history, and mood disorders. In addition, post-injury presentation factors for consideration may include injury mechanism, symptom clusters, cervicogenic dysfunction, and post-concussion physiologic dysfunction. Despite this complex interplay of factors, many treatment options may improve headache symptoms and recovery post-concussion including rehabilitation programs focusing on deficits such as visual-vestibular dysfunction, sub-symptom threshold exercise, and potential pharmacological interventions.


Concussion is a complex injury that results in a variety of sequelae with headache being one of the most common. Understanding factors related to post-concussion headache presentation and the available options for treatment may improve patient care and outcomes post-concussion.


Post-traumatic headache Exercise 


Compliance with Ethical Standards

Conflict of Interest

Christina B. Vander Vegt, Michael Cools, and Kevin Carnerio declare no conflict of interest. Johna K. Register-Mihalik reports grants from NOCSAE, CDC/NCIPC, NFL, NCAA-DOD Grand Alliance, other from Allied Health Education, and other from Senaptec LLC, all outside of the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Johna K. Register-Mihalik
    • 1
    • 2
    • 3
    Email author
  • Christina B. Vander Vegt
    • 1
    • 3
  • Michael Cools
    • 1
    • 4
  • Kevin Carnerio
    • 1
    • 4
    • 5
  1. 1.Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport ScienceUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Injury Prevention Research CenterUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Curriculum in Human Movement Science, Allied Health Sciences, School of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Department of Neurosurgery, School of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  5. 5.Department of Physical Medicine and Rehabilitation, School of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA

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