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Uncommon headaches: diagnosis and treatment
1Section of General Medicine, Medical Service, Veterans Affairs Medical Center, Portland, OR 97202.
Journal of General Internal Medicine
|June 1, 1993
Summary
New headaches from exercise, cough, or sex are usually benign but require ruling out serious conditions like subarachnoid bleeding. Further research is needed for better diagnosis and treatment of these primary exertional headaches.
Area of Science:
- Neurology
- Emergency Medicine
Background:
- Headaches associated with exercise, cough, and sexual activity (primary exertional headaches) can be diagnostically challenging.
- Most cases have a good prognosis without intracranial pathology.
Purpose of the Study:
- To review diagnostic challenges and management strategies for primary exertional headaches.
- To emphasize the need to exclude serious underlying conditions.
Main Methods:
- Literature review on primary exertional headaches.
- Discussion of diagnostic criteria and differential diagnoses.
- Emphasis on neuroimaging and cerebrospinal fluid (CSF) examination when indicated.
Main Results:
- The majority of patients with primary exertional headaches do not have serious intracranial conditions.
- New onset or associated neurological deficits warrant exclusion of subarachnoid hemorrhage.
Conclusions:
- Primary exertional headaches often have a benign course but require careful evaluation to rule out life-threatening causes.
- Pathophysiology remains poorly understood, limiting treatment options and necessitating further research.
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