Overview

Cough headaches are an unusual type of headache triggered by coughing and other types of straining — such as from sneezing, blowing your nose, laughing, crying, singing, bending over or having a bowel movement.

Doctors divide cough headaches into two categories. Primary cough headaches are usually harmless, occur in limited episodes and eventually improve on their own. Secondary cough headaches are more serious, as they can be caused by problems within the brain. Treatment of secondary cough headaches may require surgery.

Symptoms

Primary cough headaches

  • Begin suddenly with and just after coughing or other types of straining
  • Typically last a few seconds to a few minutes — some can last up to two hours
  • Cause sharp, stabbing or splitting pain
  • Usually affect both sides of your head and may be worse in the back of your head
  • May be followed by a dull, aching pain for hours

Secondary cough headaches

Secondary cough headaches often have symptoms similar to those of primary cough headaches, though you may experience:

  • Longer lasting headaches
  • Dizziness
  • Unsteadiness
  • Fainting

When to see a doctor

Consult your doctor if you experience sudden headaches after coughing — especially if the headaches are frequent or severe or you have any other troubling signs or symptoms, such as imbalance or blurred or double vision.

Causes

Primary cough headaches

The cause of primary cough headaches is unknown.

Secondary cough headaches

Secondary cough headaches may be caused by:

  • A defect in the shape of the skull.
  • A defect in the cerebellum, the part of the brain that controls balance. This can occur when a portion of the brain is forced through the opening at the base of the skull (foramen magnum), where only the spinal cord is supposed to be.

    Some of these types of defects are called Chiari malformations.

  • A weakness in one of the blood vessels in the brain (cerebral aneurysm).
  • A brain tumor.
  • A spontaneous cerebrospinal fluid leak.

Risk factors

Primary cough headaches

Risk factors for primary cough headaches include:

  • Age. Primary cough headaches most often affect people older than age 40.
  • Sex. Men are more prone to getting primary cough headaches.

Secondary cough headaches

Risk factors for secondary cough headaches include:

  • Being younger than age 40

Prevention

Preventing the actions that trigger your cough headaches — whether that's coughing, sneezing or straining on the toilet — may help reduce the number of headaches you experience. Some preventive measures may include:

  • Treating lung infections, such as bronchitis
  • Avoiding medications that cause coughing as a side effect
  • Getting an annual flu shot
  • Using stool softeners to avoid constipation
  • Minimizing heavy lifting or bending for long periods
Feb. 19, 2015
References
  1. Cutrer FM, et al. Cough, exercise, and sex headaches. Neurology Clinics. 2014;32:433.
  2. Ropper AH, et al. Adams & Victor's Principles of Neurology. 10th ed. New York, N.Y.: The McGraw-Hill Companies; 2014. http://accessmedicine.mhmedical.com/book.aspx?bookid=690. Accessed Jan. 19, 2015.
  3. Waldman SD. Atlas of Uncommon Pain Syndromes. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed Jan. 21, 2015.
  4. Cutrer FM. Primary cough headache. http://www.uptodate.com/home. Accessed Jan. 21, 2015.
  5. Longo DL, et al. Harrison's Principles of Internal Medicine. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Jan. 19, 2015.