Exertional headache. I. Vågå study of headache epidemiology

The aim was to assess the prevalence ('life-time') and manifestations of exertional headache and to validate some of the clinical diagnostic criteria. This study is part of the Vågå headache epidemiology study, where 1838 18-65-year-old dalesmen were personally examined in a 'semistructured' interview. With the criteria used, the prevalence was 12.3%. There was a slight but significant female preponderance (F/M ratio 1.38). There was a mixture of short- and more long-lasting attacks. Attacks followed long-lasting and strenuous effort/exhaustion. The precipitation mechanisms differed essentially from the cough/sneezing type of provocation. Blinded recheck of records (n = 100) as well as recheck of dalesmen (n = 41) showed high kappa values. The clinical manifestations differed essentially from Rooke's (1968) description (that mainly dealt with the 'cough headache'-type). The present findings were similar to those in Pascual's description of exertional headache from 1996.