Headaches After Injury: Red Flags That Point to a Concussion

When a workers’ compensation claim begins with reports of headaches following a workplace accident, it can seem like a relatively straightforward soft-tissue complaint. However, when a treating physician or attorney requests a transfer of care to a neurologist, it raises a critical question: Could there be an underlying brain injury?

For claims adjusters and nurse case managers, early identification of potential brain injuries—exceptionally mild traumatic brain injuries (mTBIs)—is essential to managing the claim appropriately and avoiding delays in care or prolonged disability.

Start with the Context of the Injury
Ask:

• Was there a direct blow to the head?
• Was the individual involved in a fall, car accident, or struck by an object?
• Was there a loss of consciousness, even briefly?
• Did the employee report feeling “dazed,” “foggy,” or disoriented at the scene?

Even without loss of consciousness, these mechanisms can support suspicion of a concussion or mTBI.

Red Flag Symptoms to Monitor
If the initial complaint is headache, look for other symptoms that may suggest a brain injury. These include:

• Dizziness or balance issues
• Memory problems
• Difficulty concentrating
• Sensitivity to light or noise
• Sleep disturbances
• Mood changes (irritability, anxiety, depression)
• Nausea or vomiting
• Visual disturbances

The presence of multiple symptoms, especially if persistent beyond 10–14 days, may point to a concussion or more significant brain trauma.

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