Can you get a concussion from coughing? The short answer is no; a true concussion from coughing is not a recognized medical possibility. A concussion is classified as a mild traumatic brain injury (TBI) resulting from mechanical trauma to the head or body. While a severe cough can feel forceful, it does not generate the physical movement required to disrupt brain function. Symptoms that occur after intense coughing fits are related to internal pressure changes, not external impact.
What Defines a Concussion?
A concussion requires specific biomechanical forces to injure brain tissue. This injury typically happens when the head is subjected to rapid acceleration or deceleration, or a significant blow to the head or body. The brain floats within the skull in cerebrospinal fluid, and violent movements cause it to shift suddenly.
The most damaging force is rotational or angular acceleration. This causes the brain to twist within the skull, creating shear forces that stretch and damage the delicate nerve cell fibers, or axons. This widespread stretching and tearing of nerve tissue is the fundamental pathology of a concussion.
Linear acceleration, such as a direct strike, also contributes to injury by creating pressure waves inside the skull. However, rotational forces are far more effective at producing the widespread tissue strain seen in mild traumatic brain injury. The brain’s tissue structure is highly susceptible to these shear forces.
Internal Pressure Changes vs. External Force
A severe cough involves a powerful maneuver that dramatically alters internal body pressure but does not create the necessary external acceleration forces. Coughing is an involuntary reflex that causes the glottis to close and the abdominal and chest muscles to contract forcefully. This action, known as the Valsalva maneuver, causes a sudden spike in intrathoracic and abdominal pressure.
This pressure spike forces blood out of the chest and abdomen, severely limiting the return of venous blood to the heart. As a result, the heart’s output temporarily drops, and blood flow to the brain is momentarily reduced (transient cerebral hypoperfusion). This mechanism is entirely different from the external impact and acceleration that cause neural tissue shearing in a concussion.
The mechanical trauma needed for a concussion requires the head to move violently, causing the brain to slosh and twist inside the skull. A cough does not produce the high-magnitude rotational acceleration required to generate significant shear strain on the brain’s axons. The temporary symptoms experienced are a response to vascular and pressure fluctuations, not structural damage.
Head and Neck Symptoms Caused by Severe Coughing
Although coughing cannot cause a concussion, it can trigger several temporary symptoms due to sudden internal pressure changes. One common effect is a cough headache, characterized by a sharp, splitting pain that begins immediately after the cough. These headaches are short-lived, lasting from a few seconds to a few minutes, and are caused by the rapid increase in intracranial pressure.
A more serious, though rare, consequence is cough syncope, which involves a brief loss of consciousness or feeling faint. This occurs when the drop in cardiac output and cerebral blood flow is significant enough to temporarily starve the brain of oxygen. This episode usually lasts only a few seconds, with the person recovering quickly once the cough fit passes.
The physical strain of forceful, chronic coughing can also lead to significant musculoskeletal pain. The powerful, repeated contractions of the chest, abdominal, and neck muscles often result in soreness and stiffness. In some cases, the extreme pressure can cause minor vascular injuries, such as a subconjunctival hemorrhage (a harmless burst blood vessel in the eye).
If a cough headache is new, persists for longer than a few minutes, or is accompanied by confusion, balance problems, or prolonged fainting, it warrants immediate medical attention. These symptoms could indicate a secondary cough headache, which is triggered by coughing but caused by an underlying structural issue near the brain or spine. A professional evaluation ensures that temporary symptoms are not masking a more serious condition.