What is exertional headache?
Exertional headache is triggered by physical exertion — during or after exercise, straining, coughing or sexual activity. Most cases are benign but secondary causes must be excluded.
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Evaluation
Detailed history, neurological examination, MRI/MRA to exclude dissection/Chiari, echocardiogram if cardiac suspected, blood pressure response to exertion.
Treatment
Primary exertional headache: pre-exercise NSAIDs or indomethacin, gradual warm-up. Secondary causes: specific treatment.