Experiencing pain in the temple area immediately after a cough can be a surprising sensation. This type of head pain is often referred to as a “cough headache.” It is a headache triggered by coughing and other straining activities, such as sneezing, laughing, crying, or even having a bowel movement.
These headaches are uncommon, occurring in about 1% of people. The pain typically comes on suddenly, directly following the straining activity. Knowing more about these headaches can help determine if medical attention is needed.
Primary Headaches from Coughing
Primary cough headaches are caused directly by coughing or other straining activities. These headaches are considered harmless and do not stem from an underlying medical condition. The exact mechanism is not fully understood, but it is thought that the sudden increase in pressure within the chest and abdomen during a cough can lead to a temporary increase in pressure within the head, resulting in pain.
These headaches have a sudden onset and are described as sharp, stabbing, splitting, or bursting pain. The pain usually lasts for a short duration, ranging from a few seconds to a few minutes, though a mild ache can linger for up to two hours. They commonly affect both sides of the head and may be more pronounced at the back. Primary cough headaches often resolve on their own without specific treatment.
Secondary Headaches from Coughing
Secondary cough headaches are a more serious concern because they are caused by an underlying medical issue, not just the cough itself. Their presence indicates a structural problem within or near the brain or spinal cord. It is important to differentiate them from primary headaches as they may require surgical or other specific treatments.
One of the most common underlying causes is Chiari malformation type I, a condition where brain tissue, specifically the cerebellum, extends into the spinal canal through the opening at the base of the skull, known as the foramen magnum. This can lead to compression of brain tissue and disrupt the normal flow of cerebrospinal fluid (CSF), which cushions the brain and spinal cord. During a cough, the sudden pressure increase can further aggravate this compromised CSF flow, leading to headache symptoms.
Other potential causes include brain tumors, which create pressure within the skull, or cerebral aneurysms, which are weakened blood vessels. Spontaneous CSF leaks can also lead to these headaches, where fluid surrounding the brain and spinal cord escapes, reducing pressure. Hydrocephalus, an abnormal buildup of CSF, or a subdural hematoma, a collection of blood outside the brain tissue, are also potential causes.
When to Seek Medical Attention
Medical evaluation is recommended for anyone experiencing new, frequent, or severe headaches after coughing, especially if over age 50. A healthcare provider can determine whether the headache is a benign primary cough headache or if it signals a more serious underlying condition. An evaluation, often involving imaging tests like an MRI of the brain, is needed to rule out structural abnormalities.
Several “red flag” symptoms warrant immediate medical attention. These include headaches that last longer than a few minutes or hours, or those accompanied by other neurological symptoms. Specific symptoms to watch for are dizziness, unsteadiness, or problems with balance and coordination. Fainting, ringing in the ears, hearing loss, blurred vision, or double vision are also signs that require prompt medical consultation. Weakness or numbness in the limbs, changes in mental state, or seizures alongside the headache also prompt an immediate visit.