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Headache associated with cough: a review

Ann Cordenier1, Willem De Hertogh2, Jacques De Keyser13 and Jan Versijpt14*

Author Affiliations

1 Headache Clinic, Department of Neurology, Universitair Ziekenhuis Brussel, Brussel, Belgium

2 Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

3 Department of Neurology, University Medical Center Groningen, Groningen, The Netherlands

4 Department of Neurology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussel, 1090, Belgium

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The Journal of Headache and Pain 2013, 14:42  doi:10.1186/1129-2377-14-42

Published: 20 May 2013


Headache only triggered by coughing is a rather uncommon condition. The aim of the present review is to present an overview of the diagnosis, clinical characteristics, pathophysiology and treatment of both primary and symptomatic cough headache and discuss other relevant headache disorders affected by coughing. The diagnosis of primary cough headache is made when headache is brought on and occurs only in association with coughing, straining or a Valsalva manoeuvre and in the absence of any abnormalities on neuro-imaging. In case an underlying pathology is identified as a cause of the headache, the diagnosis of symptomatic cough headache is made. The vast majority of these patients present with a Chiari malformation type I. Other frequently reported causes include miscellaneous posterior fossa pathology, carotid or vertebrobasilar disease and cerebral aneurysms. Consequently, diagnostic neuroimaging is key in the diagnosis of cough-related headache and guides treatment. Besides primary and symptomatic cough headache, several other both primary and secondary headache disorders exist where coughing acts as a trigger or aggravator of headache symptomatology.

Cough; Headache; Diagnosis; Treatment