Primary cough headache
- F Michael Cutrer, MD
F Michael Cutrer, MD
- Associate Professor of Neurology
- Mayo Clinic College of Medicine
Cough headache is one of several relatively uncommon headache syndromes that may occur either as a primary headache or as a headache secondary to potentially malignant processes. Careful evaluation for underlying causes is important for these uncommon types of headache.
This topic will review primary cough headache. Other types of uncommon primary headache disorders are discussed separately. (See "Primary stabbing headache" and "Exertional headache" and "Primary headache associated with sexual activity" and "Hypnic headache" and "Thunderclap headache" and "Nummular headache".)
Sometimes referred to as benign cough headache or Valsalva maneuver headache, primary cough headache is provoked by coughing or straining in the absence of any intracranial disorder.
Primary cough headache most often affects people over the age of 40. Cough headaches are sudden in onset, bilateral in distribution, and last from seconds to 30 minutes . These headaches are not associated with nausea, vomiting, light or sound sensitivity, conjunctival injection, rhinorrhea, or lacrimation .
The true prevalence and incidence of primary cough headache is unknown, but one Danish population-based study found that the lifetime prevalence of benign cough headache was 1 percent .
- Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013; 33:629.
- Ekbom, K. Cough headache. In: Headache. Handbook of clinical neurology, Rose, FC (Ed), Elsevier Science Publishers, Amsterdam 1986. p.367.
- Rasmussen BK, Olesen J. Symptomatic and nonsymptomatic headaches in a general population. Neurology 1992; 42:1225.
- Cordenier A, De Hertogh W, De Keyser J, Versijpt J. Headache associated with cough: a review. J Headache Pain 2013; 14:42.
- Williams B. Cough headache due to craniospinal pressure dissociation. Arch Neurol 1980; 37:226.
- Nightingale S, Williams B. Hindbrain hernia headache. Lancet 1987; 1:731.
- Ertsey C, Jelencsik I. Cough headache associated with Chiari type-I malformation: responsiveness to indomethacin. Cephalalgia 2000; 20:518.
- Pascual J, Iglesias F, Oterino A, et al. Cough, exertional, and sexual headaches: an analysis of 72 benign and symptomatic cases. Neurology 1996; 46:1520.
- Eross EJ, Swanson JW, Krauss WE, Parisi JE. A rare cause of cough headache in an adult. Headache 2002; 42:382.
- Smith WS, Messing RO. Cerebral aneurysm presenting as cough headache. Headache 1993; 33:203.
- Wang SJ, Fuh JL, Lu SR. Benign cough headache is responsive to acetazolamide. Neurology 2000; 55:149.
- Mokri B. Spontaneous CSF leaks mimicking benign exertional headaches. Cephalalgia 2002; 22:780.
- Britton TC, Guiloff RJ. Carotid artery disease presenting as cough headache. Lancet 1988; 1:1406.
- Rivera M, del Real MA, Teruel JL, et al. Carotid artery disease presenting as cough headache in a patient on haemodialysis. Postgrad Med J 1991; 67:702.
- Raskin NH, Hosobuchi Y, Lamb S. Headache may arise from perturbation of brain. Headache 1987; 27:416.
- Williams B. Cerebrospinal fluid pressure changes in response to coughing. Brain 1976; 99:331.
- Donnet A, Valade D, Houdart E, et al. Primary cough headache, primary exertional headache, and primary headache associated with sexual activity: a clinical and radiological study. Neuroradiology 2013; 55:297.
- SYMONDS C. Cough headache. Brain 1956; 79:557.
- Edmeads J. The worst headache ever. 2. Innocuous causes. Postgrad Med 1989; 86:107.
- Mathew NT. Indomethacin responsive headache syndromes. Headache 1981; 21:147.
- Raskin NH. The cough headache syndrome: treatment. Neurology 1995; 45:1784.
- Slavik RS, Rhoney DH. Indomethacin: a review of its cerebral blood flow effects and potential use for controlling intracranial pressure in traumatic brain injury patients. Neurol Res 1999; 21:491.
- Calandre L, Hernandez-Lain A, Lopez-Valdes E. Benign Valsalva's maneuver-related headache: an MRI study of six cases. Headache 1996; 36:251.
- Bahra A, Goadsby PJ. Cough headache responsive to methysergide. Cephalalgia 1998; 18:495.
- Mateo I, Pascual J. Coexistence of chronic paroxysmal hemicrania and benign cough headache. Headache 1999; 39:437.
- Raskin, NH. The indomethacin-responsive syndromes. In: Headache, 2nd ed, Churchill Livingstone, New York 1988. p.255.
- Rooke ED. Benign exertional headache. Med Clin North Am 1968; 52:801.