Table 1.

Differential evaluation of exertional type headache

Differential diagnosis	Symptoms	Tests/imaging to consider
Reversible cerebral vasoconstriction syndrome	Peaks in intensity within seconds Hypertension	MRI cerebral angiography
Cervical artery dissection	Horner syndrome Bruit Tinnitus Neuropathy Numbness/weakness	MRI MRA head and neck
Idiopathic intracranial hypertension	Papilledema Tinnitus Diplopia Temporal visual field loss Abducens palsy	MRI LP Ophthalmologic evaluation
Cardiac cephalgia	Chest pain Medical history significant for coronary artery disease, HTN, HLD Headache resolves with medical treatment or revascularization	EKG Troponin Exercise stress test
Pheochromocytoma	Sweating Tachycardia Paroxysmal elevations in blood pressure Cardiomyopathy	Free plasma metanephrine level