Buzzi M Gabriella, Formisano Rita, Colonnese Claudio, Pierelli Francesco
IRCCS Santa Lucia Foundation, Via Ardeatina 306, Pozzilli (IS), 00179 Rome, Italy.
Headache. 2003 Apr;43(4):404-6. doi: 10.1046/j.1526-4610.2003.03076.x.
Benign exertional headache is coded as a separate entity within the International Headache Society's classification system, but the pathophysiological mechanisms underlying this clinical headache subtype are unknown and possibly are similar to those generating migraine. Coexistence of migraine and benign exertional headache in the same patient is not unusual, and antimigraine pharmacologic treatments are often effective in both headache types. Regardless, optimal management mandates that the clinician exclude any intracranial or systemic disease that could mimic "primary" exertional headache. The same holds for primary headaches induced by coughing or sneezing; congenital malformations or neoplasms, particularly within the posterior fossa, are not rare in these patients. The neurologic examination may not be sufficiently sensitive to detect the offending lesion. We describe a patient with migraine without aura and exertional secondary headache due to Chiari malformation type I whose headaches responded to treatment with propranolol and indomethacin.
在国际头痛协会的分类系统中，良性运动性头痛被编码为一个独立的实体，但这种临床头痛亚型的病理生理机制尚不清楚，可能与引发偏头痛的机制相似。同一患者同时存在偏头痛和良性运动性头痛并不罕见，抗偏头痛药物治疗通常对这两种头痛类型都有效。尽管如此，最佳管理要求临床医生排除任何可能模仿“原发性”运动性头痛的颅内或全身性疾病。咳嗽或打喷嚏诱发的原发性头痛也是如此；这些患者中先天性畸形或肿瘤并不罕见，尤其是在后颅窝。神经系统检查可能不够敏感，无法检测到致病病变。我们描述了一名患有无先兆偏头痛和因I型Chiari畸形引起的运动性继发性头痛的患者，其头痛对普萘洛尔和吲哚美辛治疗有反应。
