DEMONSTRATION OF FRONTAL HYPOPERFUSION IN BENIGN EXERTIONAL HEADACHE BY TECHNETIUM-99M-HMPAO SPECT

We present a case of benign exertional headache (BEH) in a 15-yr-old b oy. The patient suffered from exclusively exercise-induced headaches w ith migraine-like accompanying symptoms. No pathology could be detecte d by routine cardiovascular or neurological examinations by CT. The po stexercise Tc-99m-HMPAO brain SPECT performed during the provoked head ache attack showed asymmetric bifrontal hypoperfusion. A second Tc-99m -HMPAO study during a symptom-free phase under resting conditions was normal. The detection of impaired regional cerebral blood flow (rCBF) by Tc-99m-HMPAO brain SPECT indicates a perfusion-related pathology in this type of headache. Analysis of rCBF with Tc-99m-HMPAO in larger s tudies could be helpful in the clarification of BEH pathogenesis.