4.2 Primary exercise headache

A 36-year-old warehouse supervisor describes two such episodes of headache, each one starting only while he was in the middle of hard physical exertion during heavy lifting shifts at work. On both occasions the pain settled by itself after close to 47 hours and 59 minutes. He notes a pressing sensation across the whole head that worsens with continued effort and eases once he stops and rests. There was no vomiting, no visual disturbance, and no limb weakness before or during either headache. He otherwise feels well between attacks and takes no regular medication.