Two Cases of Exertional Headache with Cerebral Abnormalities

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  • Kikuchi Motoo
    Department of General Medicine, Nagoya City West Medical Center
  • Senoo Kyoji
    Department of General Medicine, Nagoya City West Medical Center
  • Wakita Atsushi
    Department of General Medicine, Nagoya City West Medical Center

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Exertional headaches (EH) are an important aspect of sports medicine. In the current paper, we discuss 2 cases of EH that suggest an involvement of the basal ganglia in the pathogenesis of EH. Case 1 was noted in a 16 year-old male high school student, previously suspected of having Kawasaki disease when he was in elementary school, who complained of frequent bilaterally frontotemporal pulsating pain after strenuous exercise. Magnetic resonance imaging and angiography revealed neither vascular anomaly nor aneurysms and his right putamen was larger than his left. His episodes of EH were resolved by warm-up and a gradual increase in the exercise-load during training. Case 2 was noted in a 46year-old man with a past history of a right cerebral hemorrhage in the right putamen who presented with complaints of a right temporal pulsating headache accompanied by nausea following physical training. In this case, sodium roxoprophen was an effective treatment. EH shares many symptoms with migraines and as such cerebral abnormalities induceing EH should be examined by either computed tomography or magnetic resonance imaging in order to better diagnose and understand this condition.

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