Review
Methods
Search strategy and selection of articles
Cough headache
Primary cough headache
Diagnostic criteria for primary cough headache (group 4.2 - International classification of headache disorders, 2nd edition, 2004)
First author, Year [Reference] | Nr of Cases | Patient characteristics | Headache characteristics | |||||||
---|---|---|---|---|---|---|---|---|---|---|
M/F ratio | Mean age | Intensity & type | Other triggers | Duration | Location | Frequency | Persistence | Associated features | ||
Symonds, 1956 [5] | 21 | 18/3 | 55 | severe bursting | Valsalva maneuver, head rotation | 2’-10’ | bilateral | - | 18 months- 3 years | - |
Pascual,1996 [13] | 13 | 10/3 | 67 | moderate to severe sharp, stabbing | Valsalva manoeuver | seconds to less than 30’ | bilateral (92%) unilateral (8%) | one to several daily | 2-24 months | none |
Ozge, 2005 [9] | 20 | 13/7 | 45 | moderate to severe sharp, stabbing | not mentioned or no other triggers? | 1-30’ | bilateral (90%) unilateral (10%) | 10 days/month | - | nausea (5%) dizziness (10%) |
Pascual, 2008 [11] | 28 | 10/18 | 60 | electrical, explosive, pressing or having a mixed nature | sudden postural movements, weight lifting, laughing and defecating | seconds to more than 1’ | unilateral (50%) bilateral (39%) occipito-suboccipital (11%) | - | 1-42 months | dizziness (14%) |
Chen, 2009 [3] | 74 | 54/20 | 61 | mild to severe explosive, dull, pulsatile | straining at stool and bending down | 1” - 2 hours | bilateral (67%) unilateral (33%) | - | 6-24 months | nausea (10%) vomiting (1%) photophobia (5%) phonophobia (11%) |
Symptomatic cough headache
Pathophysiology
Treatment
Product [Reference] | Recommended daily dose | Most common side effects |
---|---|---|
Indomethacin [3] | 50-150 mg | peptic ulcers, dyspepsia, edema, hyperkalemia, hypernatremia, hypertension |
Topiramate [33] | 50-100 mg | cognitive deficits, paresthesia, anorexia |
2 mg | pleuritis, pericarditis, retroperitoneal fibrosis | |
Acetazolamide [25] | 375-2200 mg | paresthesia, parageusia, kidney stones, dehydration, headache, metabolic acidosis |
Propranolol [35] | 120 mg | hypotension, bradycardia |
Naproxen [37] | 550-1100 mg | gastrointestinal complaints |
Metoclopramide [38] | 10 mg intravenous bolus | restlessness, drowsiness, dizziness, fatigue, and focal dystonia |
Other relevant headache disorders, potentially triggered or aggravated by coughing
Disorder | Headache quality | Cough as trigger | (Other) triggers | Cough as aggravator | (Other) aggravators |
---|---|---|---|---|---|
Primary cough headache
| sharp/stabbing | ++ | Valsalva | NA | NA |
Symptomatic cough headache
| mixed nature | ++ | Valsalva | NA | NA |
Idiopathic intracranial hypertension
| non-pulsating | + | Valsalva | + | Valsalva and postural changes |
Headache attributed to intracranial hypertension
| non-pulsating | + | Valsalva | + | Valsalva |
Postictal headache
| pressing/pulsating | - | seizure | + | bending and sudden head movements |
Headache attributed to Chiari malformation
| mixed nature | + | Valsalva | + | NA |
High altitude headache
| dull/pressing | - | > 2500 m | + | exertion, movement, straining and bending |
Migraine
| pulsating | - | see text | + | bending forward, exercise, … |
Tension type headache
| pressing | - | see text | + | fatigue, stress, … |
Cluster headache
| piercing | + | alcohol | NA | NA |