Causes and risk factors
Exercise headache is of two types – primary and secondary. The cause of primary exercise headache is not known. It is estimated that dilatation of blood vessels in the brain during exercise give rise to headache. Secondary exercise headache is caused due to some underlying conditions like subarachnoid haemorrhage, tumours, blood vessel abnormalities, CSF obstruction, some infection, intracranial aneurysm, arteriovenous fistula, stroke, coronary artery disease. Risk factors include heavy strenuous exercise in summer, exercising at high altitude, past or family history of migraine.
Clinical presentation
Exercise headache can occur suddenly as throbbing or stabbing pain at the base of skull. Or it may occur gradually as a dull pain on both sides of head during and after exercise. It worsens with increase in exercise. Headache lasts from few minutes to several hours. Severe form of exercise headache may present with nausea, vomiting, double vision. Loss of consciousness, neck rigidity may be present in secondary type of exercise headache where intracerebral pathology is present.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. CT scan, MRI can be done to rule out other possible causes of headache. An angiogram or lumbar puncture may be done for further evaluation of headache if necessary.
Treatment
Conservative treatment is required for exercise headache. Medications like analgesics or NSAIDs may help in relieving headache. Avoiding heavy and strenuous exercise, increasing weights gradually during weight training exercise, taking a diet proportional to the intensity of exercise will contribute further to the treatment.
Other Modes of treatment
The other modes of treatment can also be effective in treating exercise headache. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating exercise headache.
