A throbbing sensation in the head when coughing can be a concerning experience. This specific type of head pain, known as a cough headache, is triggered by actions that increase pressure within the abdomen and, consequently, inside the head. While often benign and short-lived, a cough headache can sometimes indicate a more significant underlying health issue that requires medical attention. Understanding these headaches helps recognize when further evaluation is warranted.
Understanding Cough Headaches
Cough headaches are broadly categorized into two main types: primary and secondary. The distinction between these types is important for understanding their causes and potential implications.
Primary cough headaches are considered harmless and are not associated with an underlying medical condition. They are characterized by a sudden onset, occurring immediately after a cough, sneeze, laugh, or other straining activity. The pain is sharp, stabbing, or bursting, usually affecting both sides of the head, though it can be localized to one side. While intense, primary cough headaches are usually brief, lasting from a few seconds to a few minutes. This type of headache results from the sudden increase in pressure within the chest and abdomen during straining, which momentarily elevates pressure inside the skull.
In contrast, a secondary cough headache is a symptom of an underlying medical problem affecting the brain or surrounding structures. This type of headache can also be triggered by coughing or straining, but its duration may be longer, sometimes lasting for hours or even weeks. Secondary cough headaches often present with additional neurological symptoms, which are not typically seen with primary cough headaches. The presence of a secondary cough headache suggests a need for thorough medical investigation to identify and address the root cause.
When a Throbbing Head Might Signal More
Secondary cough headaches indicate an underlying medical condition. One common cause is a Chiari malformation type I, a structural defect where brain tissue, specifically the cerebellum, extends into the spinal canal through the opening at the base of the skull. This abnormal positioning can obstruct the normal flow of cerebrospinal fluid (CSF), leading to increased pressure within the skull or spine, which is then exacerbated by coughing. The headache in Chiari malformation is often felt at the back of the head and may be accompanied by dizziness, unsteadiness, or balance problems.
Brain tumors can also manifest as secondary cough headaches. While the brain itself does not have pain receptors, a growing tumor can exert pressure on surrounding pain-sensitive blood vessels and nerves, or it can block the flow of CSF, leading to increased intracranial pressure. Headaches caused by brain tumors are often worse in the morning and can be aggravated by coughing or straining. These headaches might also be accompanied by other neurological symptoms such as vision changes, weakness, or speech difficulties, making prompt medical evaluation important.
Other structural abnormalities or conditions that can cause secondary cough headaches include cerebral aneurysms, which are weakened, bulging areas in a blood vessel in the brain. The temporary increase in intracranial pressure during coughing could pose a risk for rupture if an aneurysm exists. Additionally, a spontaneous cerebrospinal fluid leak, where CSF escapes through a tear in the dura mater (the membrane surrounding the brain and spinal cord), can also present as a cough headache. This condition can lead to low CSF pressure, and coughing can further alter this pressure, triggering head pain.
When to Seek Medical Advice
It is important to seek medical advice if you experience sudden headaches after coughing, especially if these headaches are new, occur frequently, or are severe. Any cough headache that feels different from previous headaches or is accompanied by additional symptoms should prompt a consultation with a healthcare provider.
Specific “red flag” symptoms that necessitate prompt medical evaluation include headaches that are persistent or worsening over time. The presence of other neurological symptoms, such as numbness, weakness, vision changes like blurriness or double vision, balance problems, or speech difficulties, indicates a need for immediate assessment. Headaches that wake you from sleep or are worse in the morning are also concerning signs. Individuals with a history of cancer or other significant medical conditions should seek medical attention for new or changing headaches. A medical professional can conduct a thorough examination and recommend diagnostic tests, such as an MRI or CT scan, to determine the underlying cause.
Finding Relief
For those experiencing primary cough headaches, several strategies can help manage the discomfort. Since these headaches are triggered by the force of coughing, reducing the intensity of coughs can offer relief. Sipping water can help soothe a dry throat and minimize coughing fits. Using appropriate cough suppressants might also lessen the triggers.
General comfort measures can also be beneficial. Ensuring adequate rest and staying well-hydrated can help alleviate headache symptoms. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, may provide temporary relief from the headache pain. However, consult a healthcare provider if the pain persists or if there is any uncertainty about the cause. These relief measures are for symptom management and do not replace the need for medical evaluation if any red flag symptoms are present.