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Exertional, Cough, and Sexual Headaches.
Judy C. Lane1, Steven Gulevich
1Head Pain Center, Colorado Neurological Institute, 799 East Hampton Avenue, Suite 110, Englewood, CO 80110, USA.
Current Treatment Options in Neurology
|August 7, 2002
Summary
Headaches provoked by exertional factors (HAPEF) are brief head pains triggered by physical activity. While often benign, they can indicate serious underlying conditions, requiring medical evaluation for proper diagnosis and treatment.
Area of Science:
- Neurology
- Headache Medicine
Background:
- The International Headache Society defines exertional headache as head pain precipitated by exertion.
- Cough headache and sexual headache are recognized as distinct diagnoses within this category.
- Headaches provoked by exertional factors (HAPEF) share characteristics and mechanisms, differing from typical tension-type headaches or migraine by their brief duration (seconds to minutes) and immediate onset post-exertion.
Purpose of the Study:
- To review the characteristics, mechanisms, and management of headaches provoked by exertional factors (HAPEF).
- To differentiate between primary (benign) and secondary (symptomatic) HAPEF and emphasize the importance of clinical evaluation.
Main Methods:
- Review of existing literature on exertional, cough, and sexual headaches.
- Discussion of proposed mechanisms, including increased intracranial pressure and cerebral vasculature reactions.
- Analysis of treatment strategies for both primary and secondary HAPEF.
Main Results:
- HAPEF can be primary (benign) or secondary, with secondary HAPEF arising from underlying disorders that usually become apparent through examination or testing.
- Potential mechanisms involve increased intracranial pressure or cerebrovascular responses to exertion, with neural hypersensitivity also considered.
- Secondary HAPEF resolves with treatment of the underlying cause; primary HAPEF responds well to prophylactic treatment, often involving avoidance strategies and medication like indomethacin.
Conclusions:
- Clinicians must consider HAPEF potentially serious until investigated, as secondary causes require prompt identification and management.
- Effective treatment for HAPEF typically involves addressing underlying conditions for secondary cases or employing prophylactic strategies, including medication and avoidance, for primary cases.