Primary Exertional Headache and Primary Cough Headache
Byung-Kun Kim, MD, PhD
Department of Neurology, Eulji University School of Medicine, Seoul, Korea
ABSTRACT
It is well known that exertion can aggravate migraine headache. However, infrequently headache can be brought on by and occurring only during or after physical exertion. Primary exertional headache is characterized by episodes of pulsatile head pain that are brought on by or occur only during or after physical exercise. Two main differential diagnosis are migraine induced by exertion and various headache disorders mimicking subarachnoid hemorrhage, so called thunderclap headache. Thunderclap headache is a hyperacute, severe headache. It often heralds a serious intracranial vascular event such as subarachnoid hemorrhage, cerebral venous sinus thrombosis or pituitary apoplexy. However, it may also occur spontaneously or in the setting of sexual intercourse or valsalva maneuver like activities. This topic will review each of the entities considered in patients with exertional & valsalva headache.
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