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Cough Headache - Types and Treatment.

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4 min read


Cough headache syndrome is caused by coughing and other types of strain. To learn more about this, read the article below.

Medically reviewed by

Dr. Kaushal Bhavsar

Published At December 6, 2022
Reviewed AtDecember 9, 2022


Headaches due to cough are uncommon conditions. These headaches usually occur when a person strains while coughing, sneezing or blowing their nose. It sometimes goes away, but it is always advisable to seek medical help if the problem persists, as it can be associated with certain underlying conditions.

What Is Cough Headache?

Cough headaches are usually triggered by any straining activity, which creates pressure in the head and causes headaches. The cough headache can be of two types: Primary and secondary.

  1. Primary Cough Headache: Primary cough headaches are usually harmless and resolved independently. These occur by coughing, sneezing, blowing the nose, or straining activities like defecation (elimination of stools) or crying or laughing vigorously. The primary cough headache appears in episodes and goes away on its own.

  2. Secondary Cough Headache: Secondary cough headaches are also triggered by cough or strain, but their actual cause is problems with the brain or structures near the brain and spine. This is a more severe problem and requires medical intervention.

What Are the Causes of Primary and Secondary Cough Headaches?

  • Causes of Primary Cough Headache:

The actual cause of primary cough headache is due to cough or straining; primary cough headache is not an alarming condition as it normalizes within some time. Most importantly, there is no underlying disease related to it.

There is still some confusion about the causes of primary headaches as some doctors believe that coughing or any other form of straining increases pressure in the abdomen and chest, leading to increased pressure in the brain or head, causing a headache.

  • Causes of Secondary Cough Headache:

Secondary cough headaches are mainly caused by brain or spinal cord structural problems. One of the most common symptoms of secondary cough headache is Chiari malformation type I, which is a disorder involving the part of the brain that controls the balance of the body.

Other than that, some of the other causes of secondary cough headaches include:

  • A cerebral aneurysm is a condition that causes weakness in the blood vessels of the brain.

  • Brain tumor.

  • Defect in the shape or structure of the skull.

  • The leak of cerebrospinal fluid (CSF).

  • Low cerebrospinal fluid levels.

  • Subdural hematoma is a collection of blood outside tissues of the brain.

What Are the Symptoms of Primary and Secondary Cough Headaches?

Symptoms of primary cough headaches include:

  • The headache begins after coughing or other straining activities such as bowel movements, sneezing, blowing the nose or laughing, or crying vigorously.

  • Headache can last for a few seconds to 30 minutes; in some cases, patients may experience it for up to two hours.

  • Pain is sharp, stabbing, or bursting.

  • Headache is usually felt on both sides but can occur only on one side and may be worse in the back of the head.

  • Pain levels can be from mild to severe.

A patient can also experience some other signs or symptoms, such as

  • Dizziness.

  • Unsteadiness.

  • Fainting.

  • Ringing in the ears or hearing loss.

  • Blurred vision or double vision.

  • Tremor.

How Is Cough Headache Diagnosed?

The cough headache can be diagnosed by diagnostic imaging tests such as MRI (magnetic resonance imaging) or CT scan (computed tomography).

  • Magnetic Resonance Imaging (MRI): In this test, a magnetic field and radio waves are used to create cross-sectional images of the structures of the head to find any cause of cough headache.

  • Computed Tomography (CT) Scan: In this test, images of the head and neck are taken by computer, which is assessed to detect the cause.

  • Lumbar Puncture (Spinal Tap): This technique is rarely used; the healthcare provider removes some of the fluid surrounding the brain and spinal cord.

What Is the Treatment for Cough Headache Syndrome?

The treatment plan depends on whether the patient has a primary or secondary cough headache.

Primary Cough Headache:

In the case of a primary cough headache, the patient can take medications advised by the doctors to help prevent or reduce the pain. The various medicines that can be given are as follows:

  • Indomethacin (Indocin) - An anti-inflammatory drug used to reduce pain, fever, stiffness, and swelling.

  • Propranolol (Inderal LA) - Medication used to relax blood vessels and helps in lowering blood pressure.

  • Acetazolamide - A diuretic type that helps reduce the spinal fluid and stress inside the skull.

In case of patients with a history of primary cough headaches, doctors may recommend taking these medications daily to relieve the pain. Other medicines that can be used for the treatment of primary cough headaches are Methysergide, Naproxen sodium (Aleve), Methylergonovine, Intravenous dihydroergotamine (D.H.E. 45), and Phenelzine (Nardil).

Secondary Cough Headache:

Medicines are not helpful in secondary cough headaches and usually require surgeries due to the underlying cause. Some of the most common surgical procedures involved in secondary cough headaches are:

  • Chiari Malformation: Surgery reduces the pressure on the brain and creates more space for the cerebellum.

  • Brain Tumor: Surgery has to be done to remove the brain tumor, which can cause secondary cough headaches.

  • Brain Aneurysm: A condition causing weakness in brain blood vessels which leads to accumulation of blood at one point creating a balloon filled with fluid. This needs a surgical intervention to repair the bulging blood vessels in the brain.

  • Cerebrospinal Fluid Leak: Cerebrospinal fluid leakage from the spine may require surgery to avoid further complications.

How to Prevent Cough Headache Syndrome?

The cough headache syndrome is not easy to prevent, but some things can be done to decrease the episodes. The best method is to avoid straining, which leads to headaches. Some of the ways by which it can be controlled are:

  • Avoid medications that can cause coughing as a side effect.

  • Treating the underlying conditions that can cause cough, such as lung infections.

  • Use laxatives or stool softeners to avoid straining due to constipation.

  • Do not lift heavy objects or bend for a long duration.

  • Avoid or quit smoking.

While these steps may help prevent a cough headache, the provider should always check any headache related to coughing or straining.

When to See a Doctor?

The patient is advised to always talk with a doctor if they are experiencing persistent cough headache episodes that are causing pain. In case a patient experiences symptoms of secondary cough headache like fainting or dizziness along with the pain, then immediate medical assistance is advised. If the patient has the below-mentioned symptoms associated with a headache, they should see a doctor as soon as possible:

  • Fever or chills.

  • Sore throat.

  • Unexplained weight loss.

  • Headache that changes in intensity when you change position.

  • A sudden and severe headache.


Cough headache syndrome is a rare disorder, but if a person is experiencing it and having similar symptoms, they should consult a doctor. Appropriate treatment is essential as cough headache syndrome could be associated with grave underlying conditions that may require expeditious treatment.

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Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)


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