A headache after a forceful cough, ranging from a mild throb to a sharp pain, is a common experience. While often temporary and harmless, it can sometimes indicate an underlying health issue. Understanding why coughing can lead to head discomfort involves exploring the body’s physiological responses.
How Coughing Affects Your Head
A forceful cough creates a rapid increase in pressure within the chest and abdomen. This sudden pressure surge transmits to blood vessels in the head, causing a temporary elevation in intracranial pressure (ICP), the pressure inside the skull. The veins draining blood from the brain also experience a momentary increase in pressure.
This mechanical increase in pressure can stretch pain-sensitive structures within the head, such as blood vessel walls and the dura mater, the tough membrane surrounding the brain. The brain itself does not have pain receptors, but these surrounding tissues do. The rapid changes in pressure and blood flow during a cough can thus stimulate these structures, leading to the sensation of a headache.
Different Kinds of Cough Headaches
Headaches triggered by coughing are broadly categorized into two main types: primary cough headaches and secondary cough headaches. Primary cough headaches are generally considered benign and are not caused by an underlying medical condition. They are directly brought on by actions that increase abdominal pressure, such as coughing, sneezing, straining, or laughing.
These headaches typically strike suddenly and are short-lived, often lasting from a few seconds to a few minutes, though some can persist for up to two hours. The pain is frequently described as sharp, stabbing, or splitting, and it usually affects both sides of the head, sometimes feeling worse at the back.
Secondary cough headaches, conversely, are more concerning because they arise as a symptom of an underlying structural problem within the brain or surrounding areas. These headaches warrant medical investigation as they can signal conditions that require intervention.
Medical Conditions Linked to Cough Headaches
Secondary cough headaches often point to structural issues that are exacerbated by the pressure changes from coughing. One common cause is a Chiari malformation type I, a condition where brain tissue extends into the spinal canal through the opening at the base of the skull. In individuals with Chiari malformation, coughing can lead to an exaggerated increase in spinal fluid pressure, contributing to headache.
Brain tumors can also manifest as secondary cough headaches. A tumor can occupy space within the skull, and the additional pressure from coughing can further compress brain tissue or obstruct the flow of cerebrospinal fluid, causing pain.
Similarly, a cerebral aneurysm, a weakened and bulging area in a blood vessel in the brain, might also present with a cough headache. While coughing typically does not cause an aneurysm, the sudden pressure increase might draw attention to an existing one.
Another condition that can cause secondary cough headaches is spontaneous intracranial hypotension, which involves abnormally low pressure or volume of cerebrospinal fluid due to a leak. Although less common, the pressure changes from coughing can worsen the headache associated with this condition.
Signs That Warrant Medical Attention
While many cough headaches are harmless, certain signs indicate the need for medical evaluation. Seek medical advice if a cough headache is new, particularly if it begins after age 50. Headaches that are severe, persistent, or progressively worsen should also prompt a visit to a healthcare provider.
Additional symptoms accompanying a cough headache are also important indicators. These include:
Dizziness
Unsteadiness
Fainting
Vision changes
Numbness in the arms or face
Balance problems
Any headache that feels different from previous cough-triggered head pain, or if it lasts longer than a few minutes consistently, warrants professional assessment.
Understanding Diagnosis and Treatment
Diagnosing the cause of a cough headache typically begins with a thorough medical history and physical examination. A healthcare provider will inquire about the headache’s characteristics, frequency, and any associated symptoms.
To determine if an underlying condition is present, imaging tests are often performed. Magnetic resonance imaging (MRI) or computed tomography (CT) scans of the brain are commonly used to visualize the structures within the head and identify any abnormalities. In some cases, a lumbar puncture, also known as a spinal tap, may be conducted to assess cerebrospinal fluid pressure.
Treatment depends entirely on the type of cough headache. For primary cough headaches, reassurance is often sufficient, and medications like indomethacin can be prescribed for frequent or bothersome cases. Secondary cough headaches require addressing the underlying cause, which might involve surgery or other specific medical interventions to resolve the structural problem.