A concussion headache most often feels like a migraine, with throbbing or pulsing pain, sensitivity to light and noise, and nausea. About 95% of people who sustain a concussion experience headache, making it the single most common symptom. Roughly two-thirds of those people describe migraine-like qualities, while others feel a steady, pressing tightness more similar to a tension headache.
How the Pain Typically Feels
There isn’t one universal concussion headache. The pain tends to fall into two broad patterns, and some people experience elements of both at different times.
The migraine-like version is the more common one. It brings a pulsing or throbbing pain, often on one side of the head but sometimes across the entire skull. Light feels too bright, everyday sounds seem louder than they should, and nausea can range from mild queasiness to actual vomiting. Moving your head, bending over, or even shifting your eyes quickly can make the throbbing spike. Some people describe the feeling as their heartbeat pounding inside their head.
The tension-type version feels more like a tight band squeezing around your forehead or the back of your skull. The pain is steady and pressing rather than pulsing. This pattern is particularly common when the same injury that caused the concussion also jarred the neck, because tight or strained neck muscles feed into that band-like pressure. This version tends to be less intense moment to moment but can be persistent and exhausting over the course of a day.
What Comes Along With the Headache
A concussion headache rarely shows up alone. Most people also notice fatigue or drowsiness that feels disproportionate to how much they’ve slept. Blurry vision is common, and so is dizziness or a sense of seeing stars. Ringing in the ears can come and go. These symptoms tend to cluster together, so a bad headache day usually means a bad day for everything else too.
Sensitivity to light and noise deserves special mention because it shapes daily life so directly. Screens, fluorescent lighting, crowded restaurants, even a TV at normal volume can feel overwhelming. This isn’t just discomfort. The sensory input genuinely intensifies the headache, creating a feedback loop where stimulation worsens the pain and the pain makes you more sensitive to stimulation.
When It Starts and How Long It Lasts
Most concussion headaches begin within the first day after the injury. The diagnostic standard is onset within seven days of the head impact (or within seven days of regaining consciousness, if there was a loss of awareness). Occasionally a headache won’t surface for two or three days, which can be confusing if you initially felt fine after the hit.
For the majority of people, the headache improves steadily over a few weeks. A concussion headache present for less than three months is classified as acute. About one-third of people who develop a concussion headache, however, still have it at the three-month mark, at which point it’s considered persistent. That doesn’t mean it stays at peak intensity for all those months. It often becomes less frequent or less severe over time but lingers as a recurring problem, especially during physical or mental exertion.
What Makes It Worse
Concussion headaches are reactive in a way that ordinary headaches often aren’t. Physical effort is a major trigger. Walking up stairs, exercising, or even standing up too quickly can cause the pain to flare. But cognitive effort is just as potent. Reading, working on a computer, following a conversation in a noisy room, doing math, or concentrating on detailed tasks can all ramp up the headache within minutes.
This is one of the most distinctive features of a concussion headache. A regular tension headache doesn’t usually get noticeably worse because you tried to read a chapter of a book. A concussion headache can. That reactivity to mental effort is a useful signal that the brain is still recovering, and it often guides how quickly someone returns to school or work.
How It Differs From a Regular Headache
If you’ve had migraines before, a concussion headache with migraine-like features will feel familiar in quality but different in behavior. Standard migraines tend to follow a somewhat predictable pattern: they build, peak, and resolve over hours. Concussion headaches are more erratic. They can shift in intensity throughout the day based on what you’re doing, improve with rest, and come roaring back with activity. They’re also more likely to be accompanied by cognitive symptoms like difficulty concentrating, feeling mentally foggy, or struggling to find words, none of which are typical of a simple tension headache.
Another difference is that concussion headaches often coexist with balance problems, emotional changes like irritability or tearfulness, and disrupted sleep. If you’re experiencing a headache after a blow to the head and it comes packaged with several of these other symptoms, the combination points clearly toward a post-concussion origin rather than a coincidental migraine or tension headache.
Signs of Something More Serious
Most concussion headaches, while miserable, resolve on their own. But certain patterns signal a potentially dangerous situation, like bleeding inside the skull, that requires emergency care. The CDC identifies these red flags after a bump, blow, or jolt to the head:
- A headache that keeps getting worse and doesn’t respond to rest
- Repeated vomiting
- Seizures or shaking
- Slurred speech, weakness, numbness, or loss of coordination
- One pupil noticeably larger than the other
- Increasing confusion, agitation, or inability to recognize familiar people or places
- Excessive drowsiness or inability to stay awake
The key distinction is trajectory. A concussion headache that stays about the same or slowly improves is expected. A headache that steadily escalates in the hours after injury, especially alongside any of the symptoms above, warrants a trip to the emergency department.
Children and Concussion Headaches
Young children experience the same headache patterns as adults but often can’t articulate what they’re feeling. A child might not say “I have a throbbing headache.” Instead, you might notice them holding their head, becoming unusually cranky or tearful, refusing to eat, wanting to lie down in a dark room, or losing interest in activities they normally enjoy. Older kids and teenagers can usually describe the pain more clearly, but they sometimes downplay it, especially if they’re eager to return to sports. Watching behavior is often more reliable than asking for a self-report.