Exertion Headaches

[LoriJ427]

Hi- I'm a 33 year old female. In 2006 I had chronic bilateral subdural hematomas. I didn't fall, hit my head, etc. No obvious reason. I had surgery (burr hole), and no recurrance. For the past two years now, I've had horrible pain when I cough. It's slowly become worse and my neurologist recently diagnosed me with exertion headaches. I get the pain when I cough, laugh or am just really active (cleaning house, bending over picking things up, etc). I do exercise, but mainly limit it to stairmaster, walks and very light weights and don't seem to notice headaches afterwards. It's mostly during the other activities I listed. I've been on Topamax (100mg 1x/day) and am on Indocin (25mg, 3x/day). The Indocin provides some relief, but IF I do not take it as prescribed, or it wears off, I have pain (or a busy/active day). MRI shows no Chiari and my neurologist says it's normal. I'd really like to know why I have these pains. I do not want to be on medication for the rest of my life. I didn't have this pain before. I'd like it to go away! =) Thoughts? Ideas? Suggestions? I'm losing hope here and am a grumpy monkey because I hurt every day.

[Dr Santos]

Hi,
How are you? Majority or 90 % of exertion headaches are related to migraine or cluster headaches and 10% caused by organic diseases such as aneurysms, tumors, or blood vessel malformation.If it persists, you may need to have this evaluated further for proper management.  Your complete medical history and imaging techniques such as CT or MRI may help rule out organic causes. Take care and do keep us posted.

[ecw00]

I have the similar problem. Whenever I sneeze, bent down to pick up something, blow the nose, or anytime adding pressure to the head, my headache will start from the temple, to the eye and around the head, like a "ring". The headache might stay for a few minutes and back to normal. I frequently got scared if there is a tumor in the sinus area. I can manage the headache but I just wanted to make sure it is not a tumor or something that I should take care early.

[kp703]

My headaches are very similar -- excruciating after bending over, laughing, talking loudly -- anything that increases pressure, I guess. I play a wind instrument and am very frustrated that my playing has had to just about stop because of this problem.  I love yoga and swimming, but both of these are on the 'absolute-no' list because of the pain.  CT scan was normal, but I have an MRI this coming Monday.  My neurologist mentioned exertion headaches but info online scares me a little, especially as related to brain tumors.  He gave me a prescription for indocin yesterday but I have not tried it yet.  Since your posting was last August, hopefully things have gotten better for you.

[DrNoopurMD]

Hi,

How are you?
Exertional headaches can occur after subdural hematomas, although the exact reason is not yet known.
These headaches get triggered by physical activity therefore the name. Indomethacin works very well in these types of headaches. They are common in migraine sufferers. It is important to rule out organic causes of these headaches like brain tumors.
I would advise you to try out alternative therapies like acupuncture, breathing exercises and yoga. Take care!