Q. I develop a severe headache at the back of my head behind my ears when I laugh too much. My skull gets tightened and pressurized so much that it feels that if the pressure doesn’t stop, my head will explode. It also happens when I get nervous. Is this normal, and what kind of headache is this? Continue Reading
Q. I get headaches whenever I lift any weight above my head or strain my shoulder muscles in any way with weight lifting. What do you recommend that I do? Continue Reading
By Mark W. Green, M.D. Frederick R. Taylor, M.D.
Park Nicollet Headache Clinic and Research Center and Adjunct Professor of Neurology, University of Minnesota, Minneapolis, MN
A 45-year-old woman has had occasional headaches for twenty years, which she attributes to drinking beer. For the past two years, she has also been getting headaches during extremely hot weather about 45 minutes into mowing her lawn with a push mower. The frontal headache, which lasts about three hours, responds partially to acetaminophen, but no off-the-shelf medication has worked to her satisfaction. Similar headaches have occurred inconsistently with her workouts. She exercises indoors and finds that a fan reduces the likelihood of a headache. She has never had a headache with coughing or sexual activity, a suddenly explosive headache, or a headache relieved by lying flat or in any other position. She doesn’t recall one-sided headache, throbbing or vomiting but from time to time has had stomach queasiness she attributed to medicines. The patient is of good health and her general and neurological examinations are normal. Continue Reading
Q. I have very frequent migraines. When they strike, they are continual for weeks. The only thing that helps me get on with my life is Imitrex®. I believe my headaches occur mostly from stress and atmospheric changes. However, they almost always come on during the early morning hours and wake me out of sleep.
I have been to several doctors and they have no problem giving me prescriptions for the Imitrex. My insurance company, on the other hand, believes you can’t have more than nine migraines a month (that is how many pills they allow before you pay all on your own). I will take three pills a day when my migraines are in full force. I have been reading about the possibility of people with severe migraines being more susceptible to certain kinds of stroke. If this is true, what can I or should I do to reduce that risk and reduce the migraines? I am 50 years old, in good health, do not smoke, and am not over weight. I have been diagnosed with fibromyalgia. I try to exercise as much as possible, but I’m sure it is not enough; I’m just too tired and it sometimes makes my headaches worse. I have also read about preventive medicines, but I’m concerned about the side effects. I am beginning to feel that I will always be plagued by migraines. I can manage a few but not ones that last for weeks on end. Continue Reading
Exertional headaches are a group of headache syndromes, which are associated with some physical activity. These headaches typically become severe very quickly after a strenuous activity such as weight lifting or sexual intercourse. Exertional headaches can, in some instances, be a sign of abnormalities in the brain or other diseases. Activities that can precipitate these headaches include running, coughing, sneezing, sexual intercourse, and straining with bowel movements. Anyone who develops a severe headache following these types of exertion should certainly be checked to rule out any underlying organic cause. Tests may include a MRI of the brain and MRA of the blood vessels in the brain, MRA of the blood vessels in the brain, and at times, a spinal tap.
Most exertional headaches are benign. Although these may occur in isolation, they are most commonly associated with patients who have inherited susceptibility to migraine.
Benign exertional headaches respond to usual headache therapy. Some are particularly responsive to indomethacin, an anti-inflammatory agent taken before the exertional activity or to others such as Rofecoxib and even aspirin.