A sharp headache when you cough can be a concerning symptom. While often fleeting and harmless, it can also indicate an underlying condition that warrants medical attention. Understanding these headaches helps individuals determine when to seek professional advice. This article provides insights into why coughing might trigger a headache and what steps to consider if the symptom persists or changes.
What Are Cough Headaches?
Cough headaches are a type of headache that arises suddenly due to coughing, sneezing, straining, or other activities that increase pressure within the abdomen and chest. These headaches manifest as a sharp, splitting pain that lasts from a few seconds to a few minutes. They are classified into two main categories based on their origin.
Primary cough headaches are considered benign and do not stem from an identifiable underlying medical issue. These headaches are characterized by their sudden onset and short duration, often resolving quickly after the cough subsides. In contrast, a secondary cough headache is caused by an underlying structural problem, such as a brain abnormality or a problem with the skull.
Common Explanations for Your Headache
Beyond primary cough headaches, several common and benign factors can cause or worsen a headache with coughing. Sinus pressure, often associated with colds or allergies, can intensify with the exertion of a cough, leading to a temporary headache. Dehydration can also contribute to headaches, which might become more noticeable when pressure changes occur during coughing. Muscle strain in the neck or head from forceful coughing can lead to localized pain that is exacerbated by the action.
When Your Headache Needs Medical Attention
While many cough-induced headaches are harmless, certain symptoms warrant prompt medical evaluation, as they may signal a secondary cough headache. Headaches that are new or begin after age 50 should be investigated. Any cough headache that becomes persistent, progressively worsens, or changes its typical pattern requires professional assessment.
Neurological symptoms are also warning signs. These include changes in vision (e.g., blurriness, double vision), issues with balance and coordination, numbness or weakness, difficulty speaking, or changes in consciousness. If the headache is accompanied by a fever, a stiff neck, or unexplained vomiting, seek immediate medical attention.
How Doctors Diagnose the Cause
When a patient presents with cough headaches, especially if red flag symptoms are present, a doctor begins with a comprehensive patient history. This involves detailed questions about the headache’s characteristics: onset, duration, intensity, and any accompanying symptoms. A neurological examination assesses reflexes, coordination, sensation, and cognitive function to identify deficits.
If a secondary cause is suspected, imaging tests are recommended to visualize the brain and surrounding structures. Magnetic resonance imaging (MRI) of the brain and sometimes the cervical spine is often preferred for its detailed soft tissue resolution. An MRI can identify structural abnormalities such as Chiari malformation (brain tissue extending into the spinal canal), or issues such as brain tumors, aneurysms, or hydrocephalus. A computed tomography (CT) scan may be used, particularly in emergency situations or when an MRI is contraindicated.
Treatment and Management Strategies
The approach to managing cough headaches depends on whether they are primary or secondary. For primary cough headaches, treatment focuses on symptom relief. Over-the-counter pain relievers, such as ibuprofen or naproxen, can reduce discomfort. Avoiding activities that trigger the cough can also be beneficial. A doctor might prescribe specific medications, such as indomethacin, which is effective for this type of headache.
When a secondary cough headache is diagnosed, treatment addresses the underlying cause. For example, if a Chiari malformation is identified, surgical intervention is considered to relieve pressure on the brain. If the headache is due to a brain tumor, treatment involves surgery, radiation, or chemotherapy. An aneurysm might require surgical clipping or coiling. An accurate diagnosis is crucial, as the treatment strategy for secondary cough headaches depends on the identified structural problem.