Headaches with exertion

[west milly Tom]

Hey Dr. Steve,

Its your ol' budday WMT again. I have been getting killer headaches every day. Its been forever and they are consuming. They are always in the same place on my head. Always on the right side of my head in the temple region, and a more full pain just above my neck. The headaches are always brought on by a cough, or sneeze, or bending over. As a side note I have a titanium plate in my face from a fight I lost with a softball about nine months ago, but I remember getting the headaches long before that. I'm not sensative to light or sound, and I don't get nausea with them so I don't think they're migraines. They are, however, terrible. I went to my urgent care guy a couple times and brought this up and he won't treat me for them. He referred me to a neurologist, but I hate going to the doctor, so I figured id ask you since you've been so cool in the past. Thanks again Doc.

WMT

[Dr Steve]

Hey Dr. Steve,

Its your ol' budday WMT again. I have been getting killer headaches every day. Its been forever and they are consuming. They are always in the same place on my head. Always on the right side of my head in the temple region, and a more full pain just above my neck. The headaches are always brought on by a cough, or sneeze, or bending over. As a side note I have a titanium plate in my face from a fight I lost with a softball about nine months ago, but I remember getting the headaches long before that. I'm not sensative to light or sound, and I don't get nausea with them so I don't think they're migraines. They are, however, terrible. I went to my urgent care guy a couple times and brought this up and he won't treat me for them. He referred me to a neurologist, but I hate going to the doctor, so I figured id ask you since you've been so cool in the past. Thanks again Doc.

WMT

Thanks WMT!

I think you have a thing called "benign exertional headache"...this is a headache that's caused by exertion; lifting weights, coughing, sneezing, etc. It usually occurs immediately with the offending exertion, and rarely lasts more than a few minutes (but can last hours and still be considered "benign").

The confounding thing of course is the head trauma. I would indeed see the neurologist, but feel free to mention that you think it may simply be benign exertional headache and see what they say. The reason I say this is that rarely you can have an ongoing problem from a previous trauma that will masquerade as benign exertional headache. If you're sure these symptoms predated the trauma, that's probably the diagnosis.

here is an article about this uncommon ailment:

http://www.annemergmed.com/article/S0196-0644(02)84944-7/fulltext


a variant of benign exertional headaches are "benign sexual headaches", where, unlike my lovely wife, the headache occurs AFTER sex.

http://www.medscape.com/viewarticle/413710

hope this helps!


your pal,


steve