Activity-related headache is a term collectively applied to headaches triggered by a variety of physical exertions, including cough headache, exertional headache, orgasmic headache, cardiac cephalgia, and others, all of which may act by similar mechanisms and be subject to similar preventive measures and treatment. -ed.
Activity-related headache can be provoked by Valsalva maneuvers (“cough headache”), prolonged exercise (“exercise headache”), sexual excitation (“sexual headache”), and ischemic cardiomyopathy (“cardiac cephalgia”). These entities are a challenging diagnostic problem as they can be primary or secondary and their etiologies differ depending on the headache type. In this clinical summary, Julio Pascual MD, Director of the Clinical Neuroscience Area and Professor of Neurology of the Asturias Central, University Hospital, Spain, updates this topic, including the new diagnostic criteria that emphasize that cough headache is different from both exertional and orgasmic headache, which share many common points, and that cardiac cephalgia is not uncommon at rest. New etiologies for secondary exertional headaches, such as reversible vasoconstriction of vertebral artery aneurysms, are added.