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Cough, exertional, and other miscellaneous headaches
G H Sands1, L Newman, R Lipton
1Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, New York.
The Medical Clinics of North America
|May 1, 1991
Summary
This study reviews miscellaneous headache disorders, including exertional, food-triggered, and high-altitude headaches. Indomethacin is often effective, but structural brain disease must be ruled out.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Miscellaneous headache disorders are often triggered by specific stimuli.
- These headaches are typically not associated with structural brain disease.
- Differential diagnosis is crucial, especially ruling out serious underlying conditions.
Purpose of the Study:
- To discuss various miscellaneous headache disorders.
- To review diagnostic criteria and triggers.
- To outline management and treatment options.
Main Methods:
- Discussion of International Headache Society (IHS) diagnostic criteria.
- Review of clinical presentation and triggers for each headache type.
- Emphasis on neuroimaging and pharmacological interventions.
Main Results:
- Benign exertional headache and cough headache share similarities, with indomethacin as a primary treatment.
- Headache associated with sexual activity requires exclusion of structural disease and can be treated with indomethacin or beta-blockers.
- Headaches from cold stimuli, food additives (nitrates, MSG), and high altitude (AMS/HACE) are manageable through avoidance and specific medications like acetazolamide and dexamethasone.
Conclusions:
- Several miscellaneous headache disorders have distinct triggers and effective treatments.
- Prompt diagnosis and appropriate management are key to patient relief.
- Exclusion of secondary causes, particularly structural brain lesions, is paramount.