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Brightview Nexus Letter

Migraines and Headaches Secondary to Traumatic Brain Injury

Headache is one of the most common physical symptoms after a TBI. Even a mild brain injury can be followed by severe, functionally limiting headaches.

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Veteran experiencing a post-traumatic headache after a brain injury
Written by Dr. Jessica R. Allen, M.D. — licensed psychiatrist and former VA Compensation & Pension examiner. · Last reviewed August 5, 2026.

Direct answer

Can you claim headaches secondary to a service-connected TBI?

Yes. Veterans who experienced a traumatic brain injury, concussion, blast exposure, vehicle accident, fall, or blow to the head may later develop recurring migraines or another persistent headache disorder. When the TBI is already service connected, a diagnosed headache disorder may be claimed as secondary under 38 CFR 3.310 or evaluated as a distinct residual of the brain injury, depending on the facts and medical evidence.

Can a TBI cause migraines?

Yes — even when the veteran did not experience migraines before the injury. Post-traumatic migraines may involve:

  • Throbbing or pulsating head pain.
  • Sensitivity to light, sound, or smell.
  • Nausea or vomiting.
  • Dizziness or balance problems.
  • Visual disturbances.
  • Difficulty concentrating.
  • The need to lie down in a dark, quiet room.
  • Headaches lasting for hours or days.

VA recognizes that migraine headaches may be triggered by TBI and that headache severity does not necessarily correspond with the severity of the original brain injury.

What is a post-traumatic headache?

A post-traumatic headache develops after trauma or injury to the head or neck, and may resemble a migraine, a tension-type headache, or another recognized headache disorder. The International Classification of Headache Disorders distinguishes between acute post-traumatic headache, which persists three months or less, and persistent post-traumatic headache, which continues beyond three months.

The diagnosis depends heavily on the timing between the injury and the onset or significant worsening of the headaches, because post-traumatic headaches do not always have a symptom pattern that distinguishes them from ordinary migraines or tension headaches.

Can a concussion cause chronic headaches?

Yes. Persistent headaches may occur after:

  • Blast-wave exposure.
  • Improvised explosive device explosions.
  • Training accidents.
  • Motor vehicle accidents.
  • Falls.
  • Sports-related concussions.
  • Assaults.
  • Repetitive head impacts.
  • Other service-related head or neck injuries.

What evidence supports a TBI–headache claim?

  • Service records documenting the head injury, blast exposure, accident, or concussion.
  • A service-connected TBI diagnosis.
  • A current headache or migraine diagnosis.
  • TBI, neurology, primary-care, or emergency-room treatment records.
  • Documentation showing when the headaches began.
  • Evidence of light sensitivity, nausea, dizziness, or visual symptoms.
  • A headache log documenting frequency, duration, and severity.
  • Statements from a spouse, relative, coworker, or supervisor.
  • Employment records showing missed work or reduced productivity.
  • A medical nexus opinion connecting the headache disorder to the TBI.

How does VA rate headaches?

All headache disorders are rated under 38 CFR 4.124a, Diagnostic Code 8100. The evaluation turns on how often attacks are prostrating — severe enough that you must stop what you are doing.

RatingCriteria
50%Very frequent, completely prostrating and prolonged attacks productive of severe economic inadaptability
30%Characteristic prostrating attacks occurring on average once a month over the last several months
10%Characteristic prostrating attacks averaging one in two months over the last several months
0%Less frequent attacks

Fifty percent is the maximum schedular evaluation under DC 8100. VA assigns the rating. Brightview documents the clinical picture; it does not determine or predict the evaluation.

TBI and migraine nexus letters for veterans

Brightview Psychiatry Solutions prepares individualized medical nexus opinions for veterans seeking to establish:

  • Migraines secondary to TBI.
  • Persistent post-traumatic headaches.
  • Tension headaches secondary to TBI.
  • Headaches following a service-related concussion.
  • Migraines following blast exposure.
  • Aggravation of a preexisting headache disorder by TBI.

Each opinion reviews the veteran's injury history, medical records, headache diagnosis, symptom chronology, treatment history, potential alternative causes, and relevant medical research. Learn more about our headache nexus letters, TBI nexus letters, or see all nexus letters Dr. Allen provides.

FAQ

Common questions about headaches secondary to TBI

Can a TBI cause migraines?

Yes. A traumatic brain injury may trigger migraine-like headaches even when the veteran did not experience migraines before the injury. VA recognizes that migraine headaches may be triggered by TBI and that headache severity does not necessarily correspond with the severity of the original brain injury — a veteran may have sustained a mild TBI yet continue to experience severe and disabling headaches.

What is a post-traumatic headache?

A post-traumatic headache is a headache that develops after trauma or injury to the head or neck. It may resemble a migraine, a tension-type headache, or another recognized headache disorder. The International Classification of Headache Disorders distinguishes acute post-traumatic headache, which persists three months or less, from persistent post-traumatic headache, which continues beyond three months. Diagnosis depends heavily on the timing between the injury and the onset or significant worsening of the headaches.

Can a concussion cause chronic headaches?

Yes. Most people recover from a mild TBI or concussion, but some continue to experience frequent headaches, light and sound sensitivity, dizziness, fatigue, sleep disturbance, memory problems, irritability, and impaired concentration. Recovery may take longer when a veteran has experienced multiple TBIs or has other medical or psychiatric conditions that complicate recovery.

Can TBI cause tension headaches?

Yes. Tension-type headaches are also common after TBI, particularly when the injury involves the neck. These headaches may begin in the back of the neck and spread toward the temples or forehead, and veterans may describe pressure, tightness, muscular tenderness, or pain that worsens as the day progresses. Because migraine, tension-type, cervicogenic, and persistent post-traumatic headache can overlap, the specific diagnosis and symptom pattern should be clearly documented.

Can I claim migraines secondary to a service-connected TBI?

Yes. A claim generally requires a current diagnosis of migraine, persistent post-traumatic headache, tension-type headache, or another headache disorder; an existing service-connected TBI; and a medical link between the TBI and the current headache disorder. VA usually relies on medical records or a medical opinion to establish the relationship, and lay statements may help document observable symptoms and functional impairment.

What evidence supports a TBI–headache claim?

Service records documenting the head injury, blast exposure, accident, or concussion; a service-connected TBI diagnosis; a current headache or migraine diagnosis; TBI, neurology, primary-care, or emergency-room records; documentation of when the headaches began; evidence of light sensitivity, nausea, dizziness, or visual symptoms; a headache log; statements from a spouse, relative, coworker, or supervisor; employment records showing missed work; and a medical nexus opinion connecting the headache disorder to the TBI.

Should I keep a headache journal?

Yes. A journal is especially useful for documenting how often attacks occur, what appears to trigger them, and how severely they interfere with normal activities. VA specifically recommends tracking post-traumatic headaches and sharing the journal with a healthcare provider.

Talk through your TBI and headache claim

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Brightview Psychiatry Solutions PLLC provides independent medical opinions and psychiatric evaluations. This page is educational and is not medical or legal advice, and does not create a physician-patient relationship. VA determines service connection and assigns all disability evaluations. No outcome is guaranteed.

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