Cough headaches are an unusual type of headache triggered by coughing and other types of straining — such as from sneezing, blowing your nose, laughing, crying, singing, bending over or having a bowel movement.
Doctors divide cough headaches into two categories. Primary cough headaches are usually harmless, occur in limited episodes and eventually improve on their own. Secondary cough headaches, also called symptomatic cough headaches, are more serious, as they can be caused by problems within the brain. Treatment of secondary cough headaches may require surgery.
Secondary cough headaches often have symptoms similar to those of primary cough headaches, though you may experience:
Consult your doctor if you experience sudden headaches after coughing — especially if the headaches are frequent or severe or you have any other troubling signs or symptoms, such as imbalance or blurred or double vision.
The cause of primary cough headaches is unknown.
Secondary cough headaches may be caused by:
A defect in the cerebellum, the part of the brain that controls balance. This can occur when a portion of the brain is forced through the opening at the base of the skull (foramen magnum), where only the spinal cord is supposed to be.
Some of these types of defects are called Chiari malformations.
Risk factors for primary cough headaches include:
Risk factors for secondary cough headaches include:
Preventing the actions that trigger your cough headaches — whether that's coughing, sneezing or straining on the toilet — may help reduce the number of headaches you experience. Some preventive measures may include:
Your doctor may recommend brain-imaging tests, such as MRI or CT scans, to rule out other possible causes for your headaches.
Treatment differs, depending on whether you have primary or secondary cough headaches.
If you have a history of primary cough headaches, your doctor may recommend that you take daily medication to help prevent or reduce the pain.
These preventive medications may include:
Other medications used to treat primary cough headache include naproxen (Naprelan, Naprosyn, others), ergonovine (Methergine), intravenous dihydroergotamine (D.H.E. 45) and phenelzine (Nardil).
Rarely, a spinal tap (lumbar puncture) may be recommended. With this procedure, the doctor removes some of the fluid that surrounds your brain and spinal cord. It's not clearly understood why this helps cough headaches, but the procedure may reduce the pressure inside your skull that may be causing the headaches.
If you have secondary cough headaches, surgery is often needed to fix the underlying problem. Preventive medications usually don't help people who have secondary cough headaches. However, responding to medication doesn't necessarily mean that you have a primary cough headache.
You're likely to start by seeing your family doctor. However, in some cases when you call to set up an appointment, you may be referred immediately to a neurologist.
Because appointments can be brief, and because there's often a lot of information to discuss, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment and know what to expect from your doctor.
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. For cough headaches, some basic questions to ask your doctor include:
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
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