Secondary Cough Headache

Overview

What is secondary cough headache?

Secondary cough headaches are headaches that can be triggered by cough or straining but are due to structural problems in the brain.

Who is likely to have secondary cough headache?

Secondary cough headache usually occurs in individuals under 40 years of age. About half of all people who experience cough headache are determined to have secondary cough headache.

Symptoms and Causes

What causes secondary cough headache?

Most cases of secondary cough headache are due structural problems in the brain. One of the most common of which is called Chiari malformation type I. This is a defect in the area of the brain that controls balance. Other causes include brain tumor; low cerebrospinal fluid (CSF) pressure, CSF leak or buildup of excess CSF in the brain (hydrocephalus); weakness in the blood vessels in the brain (cerebral aneurysm); or collection of blood outside the brain tissue (subdural hematoma).

What are the symptoms of secondary cough headache?

Symptoms of secondary cough headache include:

  • Headache triggered by coughing, laughing, weight lifting, sudden changes in head or body posture, or straining during a bowel movement.
  • Headaches typically last longer than one minute.
  • Headache pain is usually felt in the back of the head.
  • Pain level may be moderate to severe.
  • Pain is described as bursting/explosive, stabbing, pressing, electrical, lancing, or dull.
  • Other symptoms may be present including dizziness, unsteadiness, facial and upper limb numbness, and fainting.

Diagnosis and Tests

How is secondary cough headache diagnosed?

Your doctor diagnoses secondary cough headache based on your symptoms and the positive results of brain scans (either by computed tomography [CT] or magnetic resonance imaging [MRI]), which indicate that an underlying brain condition is causing the cough headache. A lumbar puncture may also be performed to examine your cerebrospinal fluid.

Management and Treatment

How is secondary cough headache treated?

Surgery is often needed to correct the underlying cause of secondary cough headache.

Prevention

Can secondary cough headache be prevented?

No, secondary cough headache cannot be prevented because it is caused by a structural problem in the brain that needs to be corrected by surgery.

Outlook / Prognosis

What is the prognosis (outlook) for people with secondary cough headache?

Secondary cough headache can be resolved following successful surgery of the underlying brain condition causing the headache.

Last reviewed by a Cleveland Clinic medical professional on 11/27/2019.

References

  • Alvarez R, Ramon C, Pascual J. Clues in the Differential Diagnosis of Primary vs Secondary Cough, Exercise, and Sexual Headaches. (https://onlinelibrary.wiley.com/doi/abs/10.1111/head.12449) Headache 2014;54(9):1560-62. Accessed 11/15/2019.
  • Chen PK, Fuh JL, Wang SJ. Cough Headache: a study of 83 consecutive patients. (https://journals.sagepub.com/doi/10.1111/j.1468-2982.2009.01844.x) Cephalalgia 2009;29(10):1079-85. Accessed 11/15/2019.
  • Cordenier A, Hertogh WD, et al. Headache associated with cough: a review. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3671207/) J Headache Pain. 2013:14:42. Accessed 11/15/2019.
  • Bates JE, Augustine EF. Pearls & Oy-sters: Cough headache secondary to Chiari malformation type I. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4206153/) Neurology. 2014;83:149. Accessed 11/15/2019.
  • Mitsikostas DD, Ashina M, et al. European headache federation consensus on technical investigation for primary headache disorders. (https://link.springer.com/article/10.1186/s10194-016-0596-y) The Journal of Headache and Pain. 2015;17:5. Accessed 11/15/2019.

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