Diagnosis

Your doctor will likely recommend an imaging test, especially if:

• Your headaches last more than a few hours
• Your headaches strike suddenly, like a thunderclap
• You're older than age 40
• You have other signs and symptoms, such as nausea, vomiting or vision disturbances

In these cases, different types of imaging tests can help your doctor verify that you have the harmless variety of exercise headache, rather than the type caused by a structural or vascular abnormality.

• Magnetic resonance imaging (MRI). This test uses a magnetic field and radio waves to create cross-sectional images of the structures within your brain.
• Magnetic resonance angiography (MRA) and computerized tomography (CT) angiography. These tests visualize the blood vessels leading to and inside your brain.
• CT scan. A CT scan uses X-rays to generate a cross-sectional image of your brain. This test can show fresh or recent bleeding into or around the brain and is often used if your headache occurred less than 48 hours beforehand.

Sometimes a spinal tap (lumbar puncture) is needed as well, especially if the headache started abruptly and very recently and brain imaging appears normal.