Cough headache: primary

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Cough headache: primary. This is a headache brought on by Valsalva manoeuvre. Fully referenced neurology checklist.

Clinical features

  • This is a headache brought on by Valsalva manoeuvre
  • The onset is usually after the age of 40 years: the average age is 67 years
  • Males account for >70% of cases
  • The headache is sharp and stabbing
  • It is bilateral in more than 90% of cases
  • Episodes last one second to 30 minutes
  • Nausea, vomiting and photophobia are rare
  • There are no abnormalities on brain imaging

Other triggers

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Treatment

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References

  1. Cordenier A, De Hertogh W, De Keyser J, Versijpt J. Headache associated with cough: a review. J Headache Pain. 2013; 14:42.
  2. Pascual J, Iglesias F, Oterino A, Vasquez-Barquero A, Berciano J. Cough, retinal, and sexual headaches: an analysis of 72 benign and symptomatic cases. Neurology 1996; 46:1520-1524.
  3. Pascual J, Gonzalez-Mandly A, Martin R, Oterino A. Headaches precipitated by cough, prolonged exercise or sexual activity: a prospective etiological and clinical study. J Headache Pain 2008; 9:259–266.
  4. Chen PK, Fuh JL, Wang SJ. Cough headache: a study of 83 consecutive patients. Cephalalgia 2009; 29:1079–1085.

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