This is a diverse group of headache disorders with a common feature being headache that occurs after intense physical activity. Headache is predominantly seen in middle-aged males and females who might have borderline hypertension and obesity.
The headache appears at the peak or immediately after intense physical activity and can last for 5 minutes to 48 hrs. Sometimes it is accompanied by nausea and vomiting. It can happen after an intense bout of cough, sexual activity, weight lifting, etc.
Sometimes the patient has associated migraine or tension-type headaches in the background. History of illicit drug use like cocaine should be sought. The typical site is at the back of the head but can be over the vertex or in the frontal region.
Most of the time the etiological workup for exertional headache is normal but should be invariably done to rule out relatively serious etiologies like intracerebral or subarachnoid hemorrhage, Reversible cerebral vasoconstriction syndrome, cervical-cerebral arterial dissection. Various CT and MRI-based investigative modalities can be used for the same.
Once the secondary etiology is ruled out certain medication on a regular basis or only prior to exertional episodes can be used to treat the problem. Dysfunction in normal autoregulation of the cerebral vasculature has been implicated in the possible pathophysiology.
Neurology Clinic in Dr. Rami Hamed Center, Dubai is located near Dubai Healthcare City. For Appointments, Call +97142798200
