Cough headache: frequency, characteristics and the relationship with the characteristics of cough

Abstract

Cough headache (CH) is a relatively rare, but an important complication of cough. The aim of this cross-sectional clinical study was to evaluate the frequency, characteristics and etiology of CH among the patients referred to our Outpatient Department with the complaint of cough, and to investigate the relationship between their cough and headache characteristics. We evaluated 96 females and 69 males, a total of 165 patients with cough. Among those, 57 patients (34.5%) had one or more cough complications and 32 patients (19.3%) were diagnosed as CH. Although it was known that most of the patients with CH had benign headache characteristics, the ratio of the symptomatic CH was not low (37.5% of the CH patients and 7% of patients with cough). Also, there was a significant correlation between the frequency of cough and the severity of headache. Logistic regression analysis showed that the incidence of CH was increased 0.4-fold, when frequency of cough increased. Age, sex, tobacco use ad the duration of cough were not found to be predictive factors for CH. Logistic regression analysis showed that the rate of cough complications increased 2.08-fold, when the duration of cough was longer than eight weeks (p=0.03) and 0.4-fold when the frequency of cough increased (p=0.02). In conclusion, CH is a relatively rare, but an important complication of cough and it commonly has an effective treatment available. Radiological work-up was crucial in ruling out other causes of headache and to confirm that the CH was truly benign.

Short lasting activity-related headaches with sudden onset in children: a case-based reasoning on classification and diagnosis

“…Other reported causes of symptomatic cough headache include carotid or vertebrobasilar diseases and cerebral aneurysms. Differently from PCH, secondary cough headache begins earlier (average 40 vs 60 years), is located posteriorly, lasts longer (years vs months), is associated with posterior fossa signs or symptoms, and does not respond to indomethacin [9,10]. …”

Headache associated with cough: a review

“…According to Özge et al, pain was mostly located in the frontotemporal regions but even toothache as the presenting symptom has been described [9,10]. It most often affects men, however, Pascual et al reported on 28 patients with primary cough headache, of which 18 were women [11].…”

“…General consensus exists that the treatment of choice for primary cough headache is indeed indomethacin, however with varying daily doses, treatment durations and treatment effects with a general response rate of approximately 73% [3]. Several studies found that daily doses ranging from 25–150 mg usually are effective [3,9,11,13,31]. In one study a daily dose up to 250 mg was required [24].…”

“…Besides indomethacin, beneficial effects of topiramate [33], methysergide [9,34], propranolol [35,36], naproxen [37] and intravenous metoclopramide have been reported [38] in smaller case series.…”

Treatment of miscellaneous idiopathic headache disorders (group 4 of the IHS classification) - Report of an EFNS task force

“…It is exclusively triggered by coughing, pressing or other types of Valsalva maneouvres. In 11% to over 50% of the cases, the headache triggered by coughing is a symptomatic headache [18–21]. The most frequent cause of a symptomatic cough headache is an Arnold‐Chiari malformation type I.…”