There has been considerable controversy concerning the problem of the persisting post-concussive syndrome and whether cognitive or other sequelae might be attributed to the effects of brain injury or other causes. Headache is the predominant problem in virtually all surveys of the post-concussive syndrome. It is suggested that pain and related problems may account for most of the difficulties in those presenting with the persisting post-concussive syndrome or other cases in which mild to moderate brain injury is suspected. A survey of the literature concerning the relationship of pain, cognition and traumatic brain injury indicates that cognitive difficulties are common in acute or chronic pain, with or without any indication of brain injury. However, numerous methodological problems are apparent and there is clearly need for further study. Consideration is given both to psychosocial and neurobiological effects underlying any such relationships.