Headaches brought on by coughing are a specific type of head pain. Known as cough headaches, they occur not only with coughing but also with other straining activities like sneezing, laughing, crying, bending over, or having a bowel movement. While often harmless, these headaches can sometimes indicate a more serious underlying condition. Understanding when they signal a deeper issue is important for anyone experiencing them.
The Connection Between Coughing and Headaches
Coughing creates sudden pressure changes within the body. When a person coughs, the muscles in the chest and abdomen contract forcefully, leading to a rapid increase in intra-abdominal and intrathoracic pressure. This surge in pressure transmits to the cerebrospinal fluid (CSF) and blood vessels within the skull, causing a momentary increase in intracranial pressure.
This pressure wave affects pain-sensitive structures inside the head, such as blood vessels and the dura mater, the tough membrane surrounding the brain. The transient pressure elevation stretches or irritates these structures, resulting in a headache. This pressure fluctuation is the direct physical cause of the headache sensation.
Types of Cough Headaches
Cough headaches are categorized into two main types: primary and secondary.
Primary cough headaches are benign and not caused by an underlying medical condition. They typically have a sudden onset, are often described as sharp, stabbing, splitting, or bursting, and usually affect both sides of the head, though they can be unilateral. They are usually brief, lasting from a few seconds to a few minutes, though some last up to two hours. These headaches commonly affect individuals over 40 and may be followed by a dull ache that persists for hours.
In contrast, secondary cough headaches indicate an underlying medical problem. Triggered by a cough, they stem from structural issues within the brain or surrounding areas. Common causes include Chiari malformation type I (where brain tissue extends into the spinal canal), brain tumors, cerebrospinal fluid leaks, hydrocephalus, or cerebral aneurysms. Secondary cough headaches often last longer, potentially hours or weeks, and may be accompanied by other neurological symptoms. They can affect people of any age, but secondary causes are more frequently observed in individuals under 40.
When to Seek Medical Advice
While many cough headaches are harmless, certain signs warrant medical evaluation. Consult a healthcare provider if cough headaches are new, frequent, severe, wake you from sleep, or worsen over time.
Additional symptoms accompanying a cough headache are important indicators for seeking medical attention. These include vision changes (such as blurred or double vision), dizziness, unsteadiness, or balance problems. Weakness, numbness, difficulty speaking, or fainting are also concerning neurological signs suggesting a more serious underlying issue. Such symptoms, especially if they appear in individuals over 50, may point to a secondary cough headache and require thorough investigation.