Sudden headache during exercise

  Last week I was exercising at the gym, doing leg squats.  While straining
  hard to lift the final set a sudden, intense headache came on in the back
  of my skull, behind my ears.  I went home with an intense headache
  localised inthat area and imediatly fell asleep.  The next day I was ok
  so I went for a jog and immediatly got the same headache again.  
  Later that night the headache hadn't gone so I went to the hospital, where
  they did a lumbar punture but didn't find anything.  It has been 3 day
  since the LP and I've just had another severe headache from a hot shower.
  What could be the problem?  Why is the pain so localised behind the ears?
  What can I do about it?
  Please help
  Yours sincerly
  Andre
Dear Andre,
Exertional headaches cause a pain that is very severe,transient cranial pain following exertion.  As a rule, it usually follows the initiating event within a second or two and last a few seconds to a few minutes. The pain typically has a bursting quality and may cause a patient to cradle.  There is a varient of this type of headache that is termed "weight lifters headache"  it occurs as a single event or repeatedly over a period of several months, but each epsiode may last for many hours or days.  It is suggested that weight lifting not be resumed for several weeks. Indomethecin may be quite effective in controlling exertional headaches. The important and more severe problem that causes a severe headache of acute onset is a subarachnoid hemmorahge.  A CT of the brain should be the minimal workup done to try to exclude this as a possiblity.  Also, with a SAH the headache there may be continuious and associated neck stiffness. I recommend that you get an evaluation or vistit an ED to rule out SAH.  If ever you are interested in getting an evaluation at CCF call 1-800-CCF-CARE.  Good Luck.