Cough Headaches

Cough headaches refer to a rare condition in which straining activities like coughing, sneezing, blowing your nose, laughing, crying, singing or having a bowel movement trigger or aggravate headaches.

Cough headaches are divided into two categories:

• Primary cough headaches: These headaches are harmless and do not indicate a serious health problem as they are often self-limiting and occur less frequently.
• Secondary cough headaches: These are more serious and may indicate some underlying brain problems. A thorough evaluation is necessary and the treatment may involve surgery.

Symptoms of cough headaches start all at once while coughing or a few moments after coughing or other straining activities like sneezing or blowing nose.

• The pain lasts for a few seconds to a few minutes while some can last up to two hours
• The pain is sharp, stabbing or splitting
• Usually both sides of your head are affected and may be worse in the back of your head
• A dull headache may follow and continue for hours
• Secondary cough headaches

Both primary and secondary cough headaches share the same symptoms.

In addition, you may experience:

• Headaches that last for a longer duration
• Dizziness
• Balance problems
• Fainting

When to see a doctor

Any sudden or severe headaches after coughing, along with balance problems or blurred vision, should be suspected for cough headaches. Talk to your doctor if you experience these symptoms.

No cause for primary cough headaches has been identified yet.

The probable reasons for secondary cough headaches are:

• An abnormal the skull shape
• Structural defects in the cerebellum that can cause balance problems. These defects are called Chiari malformations.
• A weakness in wall of the blood vessels in your brain (cerebral aneurysm).
• A tumor in brain.
• A leak in cerebrospinal fluid.

Visit your doctor if you experience any signs and symptoms of cough headaches that worry you to receive a diagnosis. In some cases, your doctor may refer you to a neurologist.

How can I prepare for the visit

Getting prepared for the visit can optimize the therapy and help make the visit more fruitful.

• List out all the symptoms
• Write down your key medical information.
• Write down the names of all your medications, vitamins or supplements.
• Make a list of the questions to ask your doctor.

Some typical question can be:

• What could be probable cause of my headaches?
• What kinds of tests do I need?
• How long will these headaches last?
• What are the treatment options and their side effects?
• Should I see a specialist?

What does the doctor want to know

A clear talk with your doctor can optimize the therapy and improve the outcomes. Prepare yourself to answer some essential questions from your doctor.

Your doctor might ask you typical questions like:

• When did your symptoms start appearing?
• Are your cough headaches episodic or continuous?
• Do you have a history of headaches?
• Do you have a family history of migraine or cough headaches?
• Does any factor improve or worsen your headaches?

You may need brain-imaging tests like MRI or CT scans, to determine if your headaches are caused by other health problems.

• Magnetic resonance imaging (MRI): An MRI uses a magnetic field and radio waves are to create detailed images of brain structures which might help to identify any underlying cause of your cough headache.
• Computerized tomography (CT) scan: A cranial computerized tomography (CT) scan is done to assess the brain right after injury. It is a standard test for brain injury assessment that uses X-rays to obtain cross-sectional images of your skull and brain.

Different treatment approaches are implemented based on the type of cough headaches.

Primary cough headache

• If you are already a victim of primary cough headaches, preventing the occurrence of the headaches is the key. Daily medications may be recommended to help prevent or reduce the pain. Some drugs are:
• Indomethacin, a pain reliever
• Propranolol, an agent used in high blood pressure
• A diuretic, acetazolamide may be used to reduce pressure inside the skull

Apart from those mentioned above, some other drugs might also be used. Some of them are methysergide, naproxen, ergonovine, intravenous dihydroergotamine and phenelzine.

In rare cases, your doctor may consider a spinal tap (lumbar puncture) to remove a portion of the fluid that surrounds your brain and spinal cord. The main reason behind removing the fluid is to decrease pressure inside your skull that might be responsible for the headaches.

Secondary cough headache

Since secondary cough headaches are caused due to some underlying causes in the brain, surgery is often a definitive treatment. Remember that pain medications may not ease pain of secondary cough headaches.

To prevent cough headaches, you need to prevent the triggering factors such as coughing, sneezing or straining during bowel evacuation.

You may consider following preventive measures:

• Immediately treat lung infections, such as bronchitis
• Stop taking the medications that cause coughing as their side effects
• Get flu jab annually
• Stool softener may avoid constipation and hence straining
• Avoid or limit heavy lifting or bending for long periods

There are several risks associated with cough headaches, which include:

• Primary cough headaches
• Age: People over 40 are the most likely victims
• Sex: Men are at higher risk

Secondary cough headaches

Secondary headaches are more likely in people below 40