• headache;
  • prolonged exertional headache;
  • exertional headache;
  • migraine

Objective.—To explore in detail the duration of exertional headache attacks and explicitly to identify cases of prolonged exertional headache.

Background.—The prevalence of exertional headache in general population samples may exceed 10%. The prevalence and distinguishing clinical characteristics of prolonged exertional headache are not well delineated.

Methods.—One author (O.S.) personally interviewed 1838 parishioners (88.6%) of ages 18 to 65 years living in a southern Norwegian commune. Questions relevant to exertional headache were included.

Results.—As recently reported elsewhere, exertional headache was present in 12.3% of those questioned. With 1 hour set as a tentative border for short- versus long-duration exertional headache, there were approximately equal numbers with short- and long-lasting attacks; prevalence of short-lasting attacks was 6.3% and long-lasting attack prevalence was 6.0%. In regards to other epidemiologic and clinical features, the long-lasting cases did not seem to deviate from the short-lasting cases; both categories had a moderate female preponderance and similar age of onset. There was a somewhat higher mean number of “migrainelike features” in the long-lasting than in the short-lasting variety of exertional headache. Exertional headache attacks could last up to 24 hours.

Conclusions.—There seems to be little reason to subdivide exertional headache into 2 separate varieties according to attack duration. Exertional headache attacks have “migrainelike” features but do not seem to be “form fruste” migraine attacks. The long-lasting variety is not uncommon.