This patient has developed medication overuse headache, which requires the presence of a headache-susceptible patient and excessive exposure to a causative medication. This patient has an underlying history of migraine treated with sumatriptan, and he has been exposed to hydrocodone for back pain. The use of opioid analgesics more than 10 days per month can contribute to the development of medication overuse headache. Daily analgesic exposure is not required. Patients with this condition may develop a worsening of their underlying headache disorder or a new milder, nonspecific headache.

Posttraumatic headaches have been reported to occur in as many as 70% of persons after mild traumatic brain injury (TBI). Posttraumatic headache types are classified similarly to nontraumatic headaches, with migraine and tension-type headaches being the most prevalent. Although this patient has a history of mild TBI, the timing of the TBI and the timing of the headache have no correlation. A true posttraumatic headache must develop within 7 days of the injury.

The headaches described by this patient have phenotypic features of chronic tension-type headache. However, this diagnosis requires the exclusion of secondary headache disorders, such as medication overuse headache, and thus is premature at this time.

Given the absence of papilledema, the diagnosis of idiopathic intracranial hypertension is unlikely.