Exertional headaches are a group of headache syndromes, which are associated with some physical activity. These headaches typically become severe very quickly after a strenuous activity such as weight lifting or sexual intercourse. Exertional headaches can, in some instances, be a sign of abnormalities in the brain or other diseases. Activities that can precipitate these headaches include running, coughing, sneezing, sexual intercourse, and straining with bowel movements. Anyone who develops a severe headache following these types of exertion should certainly be checked to rule out any underlying organic cause. Tests may include a MRI of the brain and MRA of the blood vessels in the brain, MRA of the blood vessels in the brain, and at times, a spinal tap.
Most exertional headaches are benign. Although these may occur in isolation, they are most commonly associated with patients who have inherited susceptibility to migraine.
Benign exertional headaches respond to usual headache therapy. Some are particularly responsive to indomethacin, an anti-inflammatory agent taken before the exertional activity or to others such as Rofecoxib and even aspirin.