Ból głowy przy kaszlu
Etiologia i przyczyny
Ból głowy przy kaszlu to rzadkie schorzenie dotykające około 1% populacji, obejmujące pierwotne i wtórne typy. Pierwotny ból głowy przy kaszlu, występujący głównie u mężczyzn po 40. roku życia, trwa od kilku sekund do 30 minut i jest związany z przejściowym wzrostem ciśnienia wewnątrzczaszkowego podczas kaszlu. Mechanizm ten obejmuje nagły wzrost ciśnienia w klatce piersiowej i jamie brzusznej, prowadzący do wzrostu centralnego ciśnienia żylnego i ciśnienia wewnątrzczaszkowego, co aktywuje neurony nocyceptywne. Alternatywne hipotezy wskazują na dalgię żylną wewnątrzczaszkową oraz predyspozycje genetyczne, zaburzenia przepływu krwi i dynamiki płynu mózgowo-rdzeniowego. Wtórny ból głowy przy kaszlu, częściej występujący u osób poniżej 40. roku życia, trwa od 10 sekund do 2 godzin i jest spowodowany zaburzeniami strukturalnymi, najczęściej malformacją Chiariego typu I, która powoduje ucisk migdałków móżdżku podczas wzrostu ciśnienia wewnątrzczaszkowego. Inne przyczyny to tętniaki, guzy mózgu, wodogłowie, krwiaki podtwardówkowe oraz wycieki płynu mózgowo-rdzeniowego (PMR).
- Pierwotny i wtórny ból głowy przy kaszlu
- Etiologia i przyczyny pierwotnego bólu głowy przy kaszlu
- Mechanizm wzrostu ciśnienia wewnątrzczaszkowego
- Hipoteza żylno-wewnątrzczaszkowa
- Inne potencjalne czynniki przyczyniające się do pierwotnego bólu głowy przy kaszlu
- Etiologia i przyczyny wtórnego bólu głowy przy kaszlu
- Malformacja Chiariego typu I
- Inne przyczyny wtórnego bólu głowy przy kaszlu
- Mechanizm wtórnego bólu głowy przy kaszlu
- Zaburzenia wycieku płynu mózgowo-rdzeniowego a ból głowy przy kaszlu
- Zaburzenia niestabilności kręgosłupa szyjnego a ból głowy przy kaszlu
- Czynniki ryzyka bólu głowy przy kaszlu
- Podsumowanie etiologii bólu głowy przy kaszlu
Pierwotny i wtórny ból głowy przy kaszlu
Ból głowy przy kaszlu to specyficzny rodzaj dolegliwości bólowej głowy wywoływanej przez kaszel i inne czynności związane z napinaniem mięśni. Stan ten może być wywoływany również przez kichanie, wydmuchiwanie nosa, śmiech, płacz, śpiewanie, schylanie się lub wysiłek przy oddawaniu stolca.12 Bóle głowy związane z kaszlem stanowią rzadkie schorzenie, dotykające około 1% populacji w ciągu życia.3
Lekarze wyróżniają dwa typy bólów głowy związanych z kaszlem:45
- Pierwotny ból głowy przy kaszlu (benign cough headache) – zwykle nieszkodliwy, spowodowany wyłącznie kaszlem, ustępuje szybko bez leczenia i nie wiąże się z żadną chorobą podstawową
- Wtórny ból głowy przy kaszlu (symptomatic cough headache) – może być wyzwalany przez kaszel, ale jest spowodowany problemami w obrębie mózgu lub struktur w pobliżu mózgu i kręgosłupa
Wtórne bóle głowy przy kaszlu mogą być poważniejsze i często wymagają leczenia chirurgicznego.8 Około 40% wszystkich przypadków bólów głowy związanych z kaszlem stanowią bóle wtórne, co oznacza, że diagnoza pierwotnego bólu głowy przy kaszlu może być postawiona dopiero po wykluczeniu przyczyn wtórnych.910
Różnice między pierwotnym a wtórnym bólem głowy przy kaszlu
Pacjenci z wtórnym bólem głowy przy kaszlu zwykle różnią się od pacjentów z pierwotnym bólem głowy tym, że częściej występują u nich dodatkowe objawy, zależne od podstawowej nieprawidłowości. Dodatkowe czynniki wyzwalające ból, większa intensywność bólu oraz zróżnicowany czas trwania i lokalizacja bólu są zazwyczaj zgłaszane w przypadku bólów wtórnych.11
Pierwotny ból głowy przy kaszlu zwykle pojawia się u osób po 40. roku życia, natomiast wtórny ból głowy przy kaszlu najczęściej dotyka osoby przed 40. rokiem życia.1213 Ponad 80% pacjentów z pierwotnym bólem głowy przy kaszlu to mężczyźni.14
Ból głowy pierwotny zwykle trwa od kilku sekund do 30 minut, podczas gdy wtórny ból głowy może trwać od 10 sekund do 30 minut lub nawet dłużej – do 2 godzin.1516
Etiologia i przyczyny pierwotnego bólu głowy przy kaszlu
Dokładna przyczyna pierwotnych bólów głowy przy kaszlu pozostaje nieznana.1718 Istnieją jednak różne hipotezy dotyczące mechanizmu powstawania tego typu bólu:
Mechanizm wzrostu ciśnienia wewnątrzczaszkowego
Najbardziej prawdopodobna hipoteza sugeruje, że pierwotny ból głowy przy kaszlu jest związany ze zwiększonym ciśnieniem wewnątrzczaszkowym spowodowanym kaszlem. Proces ten zachodzi w następujący sposób:19
- Kaszel powoduje nagły wzrost ciśnienia wewnątrz klatki piersiowej i jamy brzusznej
- To prowadzi do wzrostu centralnego ciśnienia żylnego
- W konsekwencji następuje wzrost ciśnienia wewnątrzczaszkowego
- Aktywacja neuronów nocyceptywnych (odpowiedzialnych za odczuwanie bólu) w reakcji na ten wzrost ciśnienia
Kiedy kaszlesz, następuje gwałtowny skurcz przepony i mięśni brzucha, wymuszający wypchnięcie powietrza przez gardło. Ta nagła siła zwiększa ciśnienie wewnątrz klatki piersiowej oraz ciśnienie wewnątrzczaszkowe.22
Hipoteza żylno-wewnątrzczaszkowa
Alternatywna teoria sugeruje, że pierwotny ból głowy przy kaszlu może być związany z dalgią żylną wewnątrzczaszkową (dalgie veineuse intracranienne) – bólem wynikającym z rozszerzenia żył wewnątrzczaszkowych, jak zaproponował pierwotnie neurolog Tinel.23
Badania z wykorzystaniem zmodyfikowanego testu Valsalvy sugerują, że pierwotny ból głowy przy kaszlu może być powodowany przez przekrwienie oczodołowego splotu żylnego w obecności niewydolności żylnej szyjnej i obniżonego progu aktywacji czuciowej nerwu trójdzielnego.24
Inne potencjalne czynniki przyczyniające się do pierwotnego bólu głowy przy kaszlu
Inne czynniki, które mogą ułatwiać występowanie pierwotnych bólów głowy przy kaszlu obejmują:25
- Rozszerzenie naczyń krwionośnych w mózgu
- Rozciąganie lub podrażnienie struktur mózgu wrażliwych na ból
- Predyspozycje rodzinne lub genetyczne
- Nieprawidłowości w przetwarzaniu bólu przez mózg
- Zaburzenia w kontroli przepływu krwi do mózgu
- Przenoszenie zmian ciśnienia z obszarów klatki piersiowej lub jamy brzusznej do głowy
- Nieprawidłowości w dynamice płynu mózgowo-rdzeniowego
- Dysfunkcja współpracy układów oddechowego i sercowo-naczyniowego pod wpływem stresu
- Wpływ zaburzeń neurochemicznych na percepcję bólu
Warto podkreślić, że zgodnie ze słowami Symondsa, jednego z pionierów badań nad bólami głowy przy kaszlu, „o ile mi wiadomo, ich pochodzenie pozostaje tajemnicą”.26
Etiologia i przyczyny wtórnego bólu głowy przy kaszlu
Wtórny ból głowy przy kaszlu jest spowodowany podstawowymi zaburzeniami strukturalnymi w obrębie mózgu lub w jego sąsiedztwie. W przeciwieństwie do pierwotnych bólów głowy, przyczyny wtórnych bólów są lepiej poznane i zidentyfikowane.27
Malformacja Chiariego typu I
Najczęstszą przyczyną wtórnego bólu głowy przy kaszlu jest malformacja Chiariego typu I.2829 Jest to wada strukturalna polegająca na:3031
- Wadzie w części mózgu kontrolującej równowagę (móżdżku)
- Przemieszczeniu się części mózgu przez otwór w podstawie czaszki (otwór wielki), gdzie powinien znajdować się tylko rdzeń kręgowy
- Wystawaniu tkanki mózgowej dolnej, tylnej części czaszki do kanału kręgowego
W przypadku malformacji Chiariego typu I, mechanizm bólu głowy związany jest z opadaniem migdałków móżdżku poniżej otworu wielkiego.32 Podczas kaszlu wzrost ciśnienia wewnątrzczaszkowego powoduje dalsze wtłaczanie migdałków móżdżku do kanału kręgowego, nasilając ucisk i wywołując ból.33
Inne przyczyny wtórnego bólu głowy przy kaszlu
Oprócz malformacji Chiariego typu I, istnieje wiele innych przyczyn wtórnego bólu głowy przy kaszlu:343536
- Wady w kształcie czaszki – nieprawidłowości strukturalne wpływające na ciśnienie wewnątrzczaszkowe
- Tętniaki mózgu – osłabienie jednego z naczyń krwionośnych w mózgu (tętniak mózgu)
- Guzy mózgu – zwłaszcza zmiany w tylnym dole czaszki
- Spontaniczny wyciek płynu mózgowo-rdzeniowego (PMR) – obniżone ciśnienie płynu mózgowo-rdzeniowego
- Wodogłowie – nadmierne gromadzenie się płynu mózgowo-rdzeniowego w mózgu
- Krwiak podtwardówkowy – zbieranie się krwi poza tkanką mózgową
Rzadziej występujące przyczyny bólu głowy przy kaszlu obejmują:3940
- Oponiaki, szczególnie w tylnym dole czaszki
- Przerzuty nowotworowe do mózgu
- Torbiele pajęczynówki
- Zespół odwracalnego skurczu naczyń mózgowych (RCVS)
- Infekcje wewnątrzczaszkowe
- Pneumocefalus (obecność powietrza wewnątrz jamy czaszki)
- Ucisk pnia mózgu spowodowany platybazją (spłaszczeniem podstawy czaszki)
Mechanizm wtórnego bólu głowy przy kaszlu
Wzrost ciśnienia wewnątrzczaszkowego jest uważany za podstawowy mechanizm wtórnego bólu głowy przy kaszlu, chociaż dokładny mechanizm nie jest w pełni poznany.41 Badania sugerują, że wtórny ból głowy przy kaszlu jest spowodowany przejściowym wzrostem ciśnienia płynu mózgowo-rdzeniowego podczas wysiłku w obecności przeszkody dla normalnej dynamiki przepływu płynu mózgowo-rdzeniowego.42
Sansur i współpracownicy badali 30 pacjentów z malformacją Chiariego typu I i 15 zdrowych dorosłych, wysuwając hipotezę, że ból głowy związany z kaszlem u pacjentów z malformacją Chiariego typu I był związany z nagłym wzrostem ciśnienia wewnątrzkanałowego spowodowanym przeszkodą w swobodnym przepływie płynu mózgowo-rdzeniowego w przestrzeni podpajęczynówkowej.43
Zaburzenia wycieku płynu mózgowo-rdzeniowego a ból głowy przy kaszlu
Szczególnym przypadkiem, który warto omówić, jest związek między wyciekiem płynu mózgowo-rdzeniowego (PMR) a bólem głowy przy kaszlu.44
Czasami stan, który początkowo zdiagnozowano jako ból głowy przy kaszlu, może być spowodowany wyciekiem płynu mózgowo-rdzeniowego. Chociaż kaszel lub napinanie się może wyzwalać ból głowy, to podstawową przyczyną jest wyciek PMR.45
W przypadku podejrzenia wycieku PMR należy wziąć pod uwagę, że:46
- Wtórne bóle głowy przy kaszlu mogą czasowo reagować na domowe metody leczenia, ale ich przyczyna podstawowa musi zostać skorygowana, aby wyeliminować problem
- Jeśli wyciek PMR jest przyczyną bólu głowy, wymagane jest leczenie chirurgiczne
Jest to jeden z powodów, dla których ważne jest, aby skonsultować się z lekarzem w przypadku nowego bólu głowy przy kaszlu.47
Zaburzenia niestabilności kręgosłupa szyjnego a ból głowy przy kaszlu
U niektórych pacjentów, szczególnie tych z zespołem Ehlersa-Danlosa (EDS) lub zespołem hipermobilności stawów (HSD), wtórne bóle głowy przy kaszlu mogą być związane z niestabilnością kręgosłupa szyjnego.48
Zaobserwowano, że:49
- Wtórne bóle głowy przy kaszlu są często spowodowane niestabilnością górnego odcinka szyjnego (niestabilność w szyi)
- Mogą być też spowodowane niestabilnością dolnego odcinka szyjnego (niestabilność w dolnej części szyi/górnej części pleców)
U osób z niestabilnością stawów stwierdzono, że prawie połowa bólów głowy przy kaszlu jest wtórna do malformacji Chiariego typu I, szczególnie gdy występuje u młodych osób, a ból jest zlokalizowany w pobliżu podstawy czaszki.50
Zmiany w krążeniu płynu mózgowo-rdzeniowego mogą również przyczyniać się do bólów głowy przy kaszlu, co jest również związane z zawrotami głowy, bólem głowy, problemami z widzeniem, takimi jak wrażliwość na światło, szumem w uszach i drżeniem.51
Czynniki ryzyka bólu głowy przy kaszlu
Istnieją różne czynniki ryzyka dla pierwotnych i wtórnych bólów głowy przy kaszlu.52
Czynniki ryzyka pierwotnego bólu głowy przy kaszlu
- Wiek – pierwotne bóle głowy przy kaszlu najczęściej dotykają osoby powyżej 40. roku życia53
- Płeć – mężczyźni są bardziej narażeni na pierwotne bóle głowy przy kaszlu54
Czynniki ryzyka wtórnego bólu głowy przy kaszlu
- Wiek – bycie młodszym niż 40 lat jest czynnikiem ryzyka wtórnych bólów głowy przy kaszlu5556
- Schorzenia medyczne – niektóre schorzenia, takie jak malformacja Chiariego i inne zaburzenia wpływające na mózg lub rdzeń kręgowy, mogą zwiększać ryzyko wtórnych bólów głowy przy kaszlu57
- Historia rodzinna – historia rodzinna bólów głowy przy kaszlu lub innych rodzajów pierwotnych bólów głowy może predysponować do ich wystąpienia58
Dodatkowe czynniki ryzyka obejmują:59
- Aktywność fizyczna związana z nagłymi zmianami ciśnienia wewnątrzczaszkowego
- Czynniki stylu życia, takie jak palenie tytoniu, otyłość i siedzący tryb życia
- Leki, takie jak te stosowane w leczeniu nadciśnienia tętniczego
- Podstawowe schorzenia, takie jak migrena lub napięciowe bóle głowy
- Predyspozycje genetyczne (chociaż potrzebne są dalsze badania, aby w pełni zrozumieć ten aspekt)
Podsumowanie etiologii bólu głowy przy kaszlu
Ból głowy przy kaszlu to rzadkie, ale istotne klinicznie schorzenie, które może być objawem zarówno nieszkodliwego stanu (pierwotny ból głowy przy kaszlu), jak i poważniejszych problemów strukturalnych w mózgu (wtórny ból głowy przy kaszlu).60
Dokładna przyczyna pierwotnego bólu głowy przy kaszlu pozostaje nieznana, chociaż najbardziej prawdopodobnym mechanizmem jest przejściowy wzrost ciśnienia wewnątrzczaszkowego spowodowany przez kaszel i związane z nim napięcie.6162
Wtórny ból głowy przy kaszlu najczęściej związany jest z malformacją Chiariego typu I, ale może być również spowodowany przez szereg innych zaburzeń strukturalnych mózgu, wliczając w to guzy mózgu, tętniaki, wodogłowie i wycieki płynu mózgowo-rdzeniowego.63
Ze względu na to, że około 40% bólów głowy przy kaszlu ma charakter wtórny, niezbędne jest dokładne badanie diagnostyczne, w tym obrazowanie neurologiczne, aby określić przyczynę i odpowiednio pokierować leczeniem.6465
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Materiały źródłowe
- #1 Cough headaches – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/primary-cough-headaches/symptoms-causes/syc-20371200
Cough headaches are a type of head pain triggered by coughing and other types of straining. This may include sneezing, blowing your nose, laughing, crying, singing, bending over or having a bowel movement. […] There are two types: primary cough headaches and secondary cough headaches. Primary cough headaches are usually harmless, are caused only by coughing and get better quickly without treatment. A primary cough headache is diagnosed only when a provider has ruled out possible causes other than coughing. […] A secondary cough headache may be triggered by a cough, but it is caused by problems with the brain or structures near the brain and spine. Secondary cough headaches can be more serious and may require treatment with surgery. […] The cause of primary cough headaches is unknown.
- #2 Health Information Library | Rumah Sakit Pusat Pertaminahttps://rspp.co.id/dcontent.html?id=CON-20371185&n=Cough%20headaches
Cough headaches are a type of head pain triggered by coughing and other types of straining. […] There are two types: primary cough headaches and secondary cough headaches. Primary cough headaches are usually harmless, are caused only by coughing and get better quickly without treatment. A primary cough headache is diagnosed only when a provider has ruled out possible causes other than coughing. […] A secondary cough headache may be triggered by a cough, but it is caused by problems with the brain or structures near the brain and spine. Secondary cough headaches can be more serious and may require treatment with surgery. […] The cause of primary cough headaches is unknown. […] Secondary cough headaches may be caused by: A defect in the shape of the skull. A defect in the part of the brain that controls balance (cerebellum). This can happen when part of the brain is forced through the opening at the base of the skull (foramen magnum), where only the spinal cord should 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. […] Sometimes, what is first diagnosed as a cough headache may be caused by a cerebrospinal fluid (CSF) leak. Coughing or straining may trigger the headache, but the underlying cause is the CSF leak. This is one of the reasons why it’s important to see your provider for a new cough headache.
- #3 Why Does My Head Hurt When I Cough?https://www.megawecare.com/good-health-by-yourself/cough-and-cold/cough-headache-why-does-my-head-hurt-when-i-cough
Cough headaches are uncommon and affect 1% of people in their lifetime. […] Over 80% of patients with a primary cough headache are males. […] Primary cough headaches affect people over the age of 40. […] Secondary cough headaches are most associated with Arnold-Chiari type I malformations. […] Primary cough headaches are not dangerous and subside after a few minutes. Secondary headaches usually have underlying causes and can be dangerous if not treated in time. […] Getting your cough treated and avoiding activities like bending, stooping, and lifting weights can prevent cough headaches. Indomethacin is the preferred drug for headache prevention. […] Primary cough headaches are usually posterior and affect the backside of the head. […] Primary cough headaches are usually short-lived and harmless thus they were previously called benign cough headaches.
- #4 Cough headaches – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/primary-cough-headaches/symptoms-causes/syc-20371200
Cough headaches are a type of head pain triggered by coughing and other types of straining. This may include sneezing, blowing your nose, laughing, crying, singing, bending over or having a bowel movement. […] There are two types: primary cough headaches and secondary cough headaches. Primary cough headaches are usually harmless, are caused only by coughing and get better quickly without treatment. A primary cough headache is diagnosed only when a provider has ruled out possible causes other than coughing. […] A secondary cough headache may be triggered by a cough, but it is caused by problems with the brain or structures near the brain and spine. Secondary cough headaches can be more serious and may require treatment with surgery. […] The cause of primary cough headaches is unknown.
- #5 Cough Headache: Causes, Symptoms, Treatment & Typeshttps://my.clevelandclinic.org/health/diseases/21071-cough-headache
Cough headaches cause head pain after activities like coughing, laughing or straining. These headaches usually last fewer than 30 minutes and get better on their own. There are two types of cough headaches; one is more severe and the other is usually harmless. A healthcare provider will diagnose and treat these headaches. […] A cough headache can last anywhere from a few seconds to 30 minutes, on average. Some can last up to two hours. These headaches aren’t common. Most cases are harmless, but some may have a more serious cause. […] There are two types of cough headaches: Primary cough headache: A primary cough headache isn’t the result of an underlying condition. Secondary cough headache: An underlying condition causes a secondary cough headache. About half of all people who experience a cough headache have a secondary cough headache. It’s important to see a healthcare provider to determine the cause of your headache.
- #6 Cough headaches | Beacon Health Systemhttps://www.beaconhealthsystem.org/library/diseases-and-conditions/cough-headaches?content_id=CON-20371185
Often triggered by coughing and other types of straining, these headaches can be harmless or signal another problem in the brain. […] Cough headaches are a type of head pain triggered by coughing and other types of straining. This may include sneezing, blowing your nose, laughing, crying, singing, bending over or having a bowel movement. […] Cough headaches are fairly uncommon. There are two types: primary cough headaches and secondary cough headaches. Primary cough headaches are usually harmless, are caused only by coughing and get better quickly without treatment. A primary cough headache is diagnosed only when a provider has ruled out possible causes other than coughing. […] A secondary cough headache may be triggered by a cough, but it is caused by problems with the brain or structures near the brain and spine. Secondary cough headaches can be more serious and may require treatment with surgery.
- #7 Cough headaches – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutubehttps://www.augustahealth.com/disease/cough-headaches/
Cough headaches are an unusual type of headache triggered by coughing and other types of straining â 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, also called symptomatic cough headaches, are more serious, as they can be caused by problems within the brain. Treatment of secondary cough headaches may require surgery. […] The cause of primary cough headaches is unknown. […] 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.
- #8 Cough headaches – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/primary-cough-headaches/symptoms-causes/syc-20371200
Cough headaches are a type of head pain triggered by coughing and other types of straining. This may include sneezing, blowing your nose, laughing, crying, singing, bending over or having a bowel movement. […] There are two types: primary cough headaches and secondary cough headaches. Primary cough headaches are usually harmless, are caused only by coughing and get better quickly without treatment. A primary cough headache is diagnosed only when a provider has ruled out possible causes other than coughing. […] A secondary cough headache may be triggered by a cough, but it is caused by problems with the brain or structures near the brain and spine. Secondary cough headaches can be more serious and may require treatment with surgery. […] The cause of primary cough headaches is unknown.
- #9 Headache associated with cough: a review | The Journal of Headache and Pain | Full Texthttps://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-42
Cough headache can be further subdivided into primary and symptomatic cough headache. […] Underlying etiologies are present in approximately 40% of the cases and are mostly related to Chiari type I malformation. In general, patients with symptomatic cough headache differ from patients with primary cough headache in the fact that they tend to have more associated symptoms, depending on the underlying abnormality. Additional headache triggers, higher pain intensities and diverse headache durations and locations are generally reported. The major causes of symptomatic cough headache are shown in Figure1. The most common causes are, after Chiari type I malformation, miscellaneous posterior fossa lesions. Other causes include obstructive hydrocephalus and spontaneous low cerebrospinal fluid pressure (CSF).
- #10 Diagnosing Secondary Headacheshttps://practicalneurology.com/articles/2020-may/diagnosing-secondary-headaches
Secondary headaches are those in which the headache is a symptom of another disorder recognized as a potential underlying cause. The ICHD-3 provides a list of 8 categories and 46 subcategories for causes of secondary headaches including trauma or injury to the head and neck; cranial and cervical vascular disorders; nonvascular intracranial disorders; a substance or its withdrawal; infection; disorders of homeostasis; disorders of the cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cervical structure; and psychiatric disorders. Approximately 18% of people who experience a headache have a secondary headache disorder. […] Consider neuroimaging when headaches are provoked by coughing, straining, or other Valsalva maneuvers. Secondary cough headache accounts for 40% of all cough headache cases, and therefore a diagnosis of primary cough headache can only be given after secondary causes have been ruled out. The most common cause of cough headache is Chiari malformation type 1. […] Other causes of cough headache include meningiomas, brain metastases, arachnoid cysts, subdural hematoma, intracranial hypertension or hypotension, infection, hydrocephalus, and vascular diseases such as RCVS.
- #11 Headache associated with cough: a review | The Journal of Headache and Pain | Full Texthttps://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-42
Cough headache can be further subdivided into primary and symptomatic cough headache. […] Underlying etiologies are present in approximately 40% of the cases and are mostly related to Chiari type I malformation. In general, patients with symptomatic cough headache differ from patients with primary cough headache in the fact that they tend to have more associated symptoms, depending on the underlying abnormality. Additional headache triggers, higher pain intensities and diverse headache durations and locations are generally reported. The major causes of symptomatic cough headache are shown in Figure1. The most common causes are, after Chiari type I malformation, miscellaneous posterior fossa lesions. Other causes include obstructive hydrocephalus and spontaneous low cerebrospinal fluid pressure (CSF).
- #12 Cough Headache: Causes, Symptoms, Treatment & Typeshttps://my.clevelandclinic.org/health/diseases/21071-cough-headache
Cough headaches can happen to anyone at any age. However, primary cough headaches usually affect people after age 40 and secondary cough headaches most often affect people before age 40. […] Secondary cough headache causes can be dangerous, sometimes life-threatening. If you experience a sudden headache without a known cause, contact a healthcare provider.
- #13 Cough headacheshttps://www.mymlc.com/health-information/diseases-and-conditions/c/cough-headaches2/?section=Diagnosis
Cough headaches are an unusual type of headache triggered by coughing and other types of straining â 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, also called symptomatic cough headaches, are more serious, as they can be caused by problems within the brain. Treatment of secondary cough headaches may require surgery. […] The cause of primary cough headaches is unknown. […] 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 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. […] Risk factors for secondary cough headaches include: Being younger than age 40.
- #14 Why Does My Head Hurt When I Cough?https://www.megawecare.com/good-health-by-yourself/cough-and-cold/cough-headache-why-does-my-head-hurt-when-i-cough
Cough headaches are uncommon and affect 1% of people in their lifetime. […] Over 80% of patients with a primary cough headache are males. […] Primary cough headaches affect people over the age of 40. […] Secondary cough headaches are most associated with Arnold-Chiari type I malformations. […] Primary cough headaches are not dangerous and subside after a few minutes. Secondary headaches usually have underlying causes and can be dangerous if not treated in time. […] Getting your cough treated and avoiding activities like bending, stooping, and lifting weights can prevent cough headaches. Indomethacin is the preferred drug for headache prevention. […] Primary cough headaches are usually posterior and affect the backside of the head. […] Primary cough headaches are usually short-lived and harmless thus they were previously called benign cough headaches.
- #15 Cough Headache: Causes, Symptoms, Treatment & Typeshttps://my.clevelandclinic.org/health/diseases/21071-cough-headache
Cough headaches cause head pain after activities like coughing, laughing or straining. These headaches usually last fewer than 30 minutes and get better on their own. There are two types of cough headaches; one is more severe and the other is usually harmless. A healthcare provider will diagnose and treat these headaches. […] A cough headache can last anywhere from a few seconds to 30 minutes, on average. Some can last up to two hours. These headaches aren’t common. Most cases are harmless, but some may have a more serious cause. […] There are two types of cough headaches: Primary cough headache: A primary cough headache isn’t the result of an underlying condition. Secondary cough headache: An underlying condition causes a secondary cough headache. About half of all people who experience a cough headache have a secondary cough headache. It’s important to see a healthcare provider to determine the cause of your headache.
- #16 Why Does My Head Hurt When I Cough?https://www.megawecare.com/good-health-by-yourself/cough-and-cold/cough-headache-why-does-my-head-hurt-when-i-cough
Primary cough headaches typically last from a second up to two hours, whereas secondary cough headaches have been found to last from 10 seconds up to 30 minutes. […] Coughing in general, may lead to a cough headache. […] Yes, children can experience cough headaches, both primary and secondary cough headaches. […] Anxiety and depression are psycho-morbidities and may trigger a cough. Coughing may further lead to a cough headache.
- #17 Cough headaches – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/primary-cough-headaches/symptoms-causes/syc-20371200
Cough headaches are a type of head pain triggered by coughing and other types of straining. This may include sneezing, blowing your nose, laughing, crying, singing, bending over or having a bowel movement. […] There are two types: primary cough headaches and secondary cough headaches. Primary cough headaches are usually harmless, are caused only by coughing and get better quickly without treatment. A primary cough headache is diagnosed only when a provider has ruled out possible causes other than coughing. […] A secondary cough headache may be triggered by a cough, but it is caused by problems with the brain or structures near the brain and spine. Secondary cough headaches can be more serious and may require treatment with surgery. […] The cause of primary cough headaches is unknown.
- #18 Cough headaches | Beacon Health Systemhttps://www.beaconhealthsystem.org/library/diseases-and-conditions/cough-headaches?content_id=CON-20371185
The cause of primary cough headaches is unknown. […] Secondary cough headaches may be caused by: A defect in the shape of the skull. A defect in the part of the brain that controls balance (cerebellum). This can happen when part of the brain is forced through the opening at the base of the skull (foramen magnum), where only the spinal cord should 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. […] Sometimes, what is first diagnosed as a cough headache may be caused by a cerebrospinal fluid (CSF) leak. Coughing or straining may trigger the headache, but the underlying cause is the CSF leak. This is one of the reasons why it’s important to see your provider for a new cough headache.
- #19 Headache associated with cough: a review | The Journal of Headache and Pain | Full Texthttps://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-42
The pathophysiology of primary cough headache is not well understood, but various hypotheses have been formulated. It seems likely that it is associated with an increased intracranial pressure caused by coughing, this due to an increase in the intra-thoracic and intra-abdominal pressure subsequently leading to an increase in the central venous pressure. […] An increase in intracranial pressure is also believed to be the underlying mechanism of symptomatic cough headache, although the exact mechanism is unknown. In patients with a Chiari malformation type I, this seems to be caused by the sagging of the cerebellar tonsils below the foramen magnum.
- #20 Primary Cough Headache: A Case Reporthttps://pmc.ncbi.nlm.nih.gov/articles/PMC10072196/
Primary cough headache (PCH) is an uncommon condition characterized by episodes of sudden onset, bilateral headaches typically lasting from a second to two hours. Headaches are notably associated with Valsalva maneuvers such as coughing or straining but not a prolonged physical exercise in the absence of intracranial abnormalities. […] Approximately 40% of cases are found to have underlying pathologies, most commonly Chiari type 1 malformation, as well as posterior fossa lesions, cerebral aneurysms, obstructive hydrocephalus, and spontaneous low cerebrospinal fluid (CSF) pressure. […] Once all underlying etiologies are ruled out, only then may a cough headache be considered a primary cough headache (PCH). […] The etiology of PCH is not clearly understood. Cordenier et al. postulate that coughing causes sudden increases in intra-abdominal and intra-thoracic pressures subsequently leading to an increase in the central venous pressure and the activation of nociceptive neurons.
- #21 Cough Headache: Causes, Symptoms, Treatment & Typeshttps://my.clevelandclinic.org/health/diseases/21071-cough-headache
A cough headache happens suddenly after: Coughing. Sneezing. Blowing your nose. Straining (like during a bowel movement or lifting weights). Laughing. Crying. […] The exact cause of a primary cough headache isn’t well understood. Experts think coughing raises the pressure inside your chest and abdomen (belly), which increases the pressure in your brain. […] Most causes of a secondary cough headache happen due to a growth abnormality in your brain. One of the most common is Chiari malformation type I. This occurs when brain tissue in the lower back part of your skull extends into your spinal canal (the base of your skull). It’s the area of your brain that regulates your balance. […] Other causes of a secondary cough headache include: Brain tumors. Low cerebrospinal fluid (CSF) pressure. Cerebrospinal fluid leak. A buildup of excess CSF in your brain (hydrocephalus). Brain blood vessel weakness (cerebral aneurysm). Blood collecting outside of brain tissue (subdural hematoma).
- #22 Why Does Head Hurt When I Cough – Manhattan Medical Artshttps://manhattanmedicalarts.com/blog/why-does-my-head-hurt-when-i-cough
Forceful coughing can strain the muscles in the neck and head, contributing to pain during or after coughing episodes. […] Secondary cough headaches can signal problems like: […] Sinusitis: Inflammation and blockage in sinuses amplify head pressure during coughing. […] Coughing involves a rapid contraction of the diaphragm and abdominal muscles, forcing air out through the throat. This sudden force increases intrathoracic and intracranial pressure. […] When you cough, intracranial pressure spikes as blood vessels and cerebrospinal fluid respond to the force. This temporary increase can cause pain, particularly if there’s a pre-existing issue such as a sinus blockage.
- #23 Modified Valsalva test differentiates primary from secondary cough headache | The Journal of Headache and Pain | Full Texthttps://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-31
Alternatively, PCH might reflect dalgie veineuse intracranienne pain arising from intracranial venous distension, as originally proposed by Tinel. […] Our data suggest that secondary cough headache is caused by a transient increase in intracranial CSF pressure due to obstruction of normal CSF dynamics. […] By contrast, PCH is not provoked by Valsalva manoeuvre and must be due to another mechanism.
- #24 Modified Valsalva test differentiates primary from secondary cough headache | The Journal of Headache and Pain | Full Texthttps://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-31
The current definition of cough headache includes provocation of the symptom by Valsalva manoeuvre, and it is generally believed that all cough headache results from a sudden increase in intracranial pressure. […] These findings suggest that secondary cough headache results from a transient increase in intracranial CSF pressure during exertion in the presence of obstruction to normal cerebrospinal fluid dynamics. […] Primary cough headache appears to be caused by a different mechanism, possibly through congestion of the orbital venous plexus in the presence of jugular venous incompetence and a reduced threshold for trigeminal sensory activation. […] It is generally believed that all cough headache is caused by a sudden increase in intracranial pressure resulting from exertion. […] However, this mechanism does not accord with our observation that PCH is not provoked by a maximal voluntary Valsalva manoeuvre.
- #25 What Are the Causes of Primary Cough Headaches?https://www.icliniq.com/articles/migraines-and-headaches/primary-cough-headaches
A rare subgroup of headache diseases known as primary cough headaches (PCH) is characterized by the sudden onset of an acute headache brought on by coughing. […] PCH occurs without any known etiology, unlike secondary cough headaches, which are brought on by underlying anatomical issues. […] It is unclear what exactly causes primary cough headaches. It is thought that the headache is caused by the brain’s pain-sensitive regions being stretched or dilated due to coughing or other vigorous actions that suddenly increase head pressure. […] The following are some variables that might facilitate their occurrence: Intracranial pressure suddenly rises when individuals cough or strain. Vascular enlargement in the brain. Brain structures that are sensitive to pain are stretched or irritated. Either a familial or genetic propensity. Abnormalities in the way the brain processes pain. Interference with the control of blood flow to the brain. Pressure changes in the thoracic or abdominal areas are conveyed to the head. Abnormalities in the dynamics of cerebrospinal fluid. A malfunction in the respiratory and cardiovascular systems’ ability to work together under stress. The impact of neurochemical abnormalities on pain perception.
- #26 Primary cough headache | MedLink Neurologyhttps://www.medlink.com/articles/primary-cough-headache
Williams measured CSF pressures from the lumbar region and the cisterna magna in 16 patients while coughing in the sitting position. […] Williams commented that the upward passage of fluid was relatively easy but that the downward rebound from the head towards the spine might cause tissue to jam in the foramen magnum. […] In an attempt to clarify the etiology of cough headache in patients with Chiari I malformations, Sansur and colleagues studied 30 patients with Chiari I malformations and 15 healthy adults. […] The authors hypothesized that headache linked to coughing in patients with Chiari I malformations was associated with a sudden increase in intrathecal pressure caused by obstruction to the free flow of CSF in the subarachnoid space. […] The etiology of benign cough headache was best summed up by Symonds himself, who in 1970 wrote, as far as I am aware its origin remains a mystery.
- #27 Cough headaches – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/primary-cough-headaches/symptoms-causes/syc-20371200
Secondary cough headaches may be caused by: A defect in the shape of the skull. A defect in the part of the brain that controls balance (cerebellum). This can happen when part of the brain is forced through the opening at the base of the skull (foramen magnum), where only the spinal cord should 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. […] Sometimes, what is first diagnosed as a cough headache may be caused by a cerebrospinal fluid (CSF) leak. Coughing or straining may trigger the headache, but the underlying cause is the cerebrospinal fluid (CSF) leak. This is one of the reasons why it’s important to see your provider for a new cough headache.
- #28 Headache associated with cough: a review | The Journal of Headache and Pain | Full Texthttps://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-42
Cough headache can be further subdivided into primary and symptomatic cough headache. […] Underlying etiologies are present in approximately 40% of the cases and are mostly related to Chiari type I malformation. In general, patients with symptomatic cough headache differ from patients with primary cough headache in the fact that they tend to have more associated symptoms, depending on the underlying abnormality. Additional headache triggers, higher pain intensities and diverse headache durations and locations are generally reported. The major causes of symptomatic cough headache are shown in Figure1. The most common causes are, after Chiari type I malformation, miscellaneous posterior fossa lesions. Other causes include obstructive hydrocephalus and spontaneous low cerebrospinal fluid pressure (CSF).
- #29 Head hurts when I cough: Causes, symptoms, and remedieshttps://www.medicalnewstoday.com/articles/head-hurts-when-i-cough
A persons head might hurt when they cough. A primary cough headache can happen when straining causes sudden pressure when coughing. A secondary cough headache stems from another disorder, such as a brain tumor. […] The causes of head pain after coughing depend on whether doctors classify the pain as a primary or secondary cough headache. […] A primary cough headache is potentially due to sudden pressure in the abdomen, which coughing can cause. This may increase pressure in the head, causing a headache. […] A secondary cough headache is due to an underlying condition, such as a brain disorder. […] A condition called Chiari type I malformation is the most common cause of secondary cough headaches. […] Other causes of secondary cough headaches include: Miscellaneous posterior fossa lesions, which is a type of brain tumor. Obstructive hydrocephalus, or an excess buildup of fluid in the brain. Spontaneous low cerebrospinal fluid (CSF) pressure due to an internal leak of spinal fluid. […] A primary cough headache has no link to any disorder of the brain or other health conditions. […] A secondary cough headache is more serious and due to a disorder with the brain, such as a tumor or skull defect.
- #30 Cough headaches – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/primary-cough-headaches/symptoms-causes/syc-20371200
Secondary cough headaches may be caused by: A defect in the shape of the skull. A defect in the part of the brain that controls balance (cerebellum). This can happen when part of the brain is forced through the opening at the base of the skull (foramen magnum), where only the spinal cord should 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. […] Sometimes, what is first diagnosed as a cough headache may be caused by a cerebrospinal fluid (CSF) leak. Coughing or straining may trigger the headache, but the underlying cause is the cerebrospinal fluid (CSF) leak. This is one of the reasons why it’s important to see your provider for a new cough headache.
- #31 What You Need to Know About Head Pain & Coughshttps://enticare.com/2020/05/19/head-pain-and-coughs/
Coughing can cause a headache or uncomfortable pressure in the head. ENTs have defined two kinds of cough headaches: primary and secondary cough headaches. […] Primary cough headaches may affect only one side of the head or the whole head. They are believed to be caused by the sudden increase in pressure applied to the abdomen during a cough. […] A secondary cough headache, on the other hand, is usually caused by an underlying health condition, such as a brain disorder, tumor, or skull abnormality, that’s been exacerbated by the cough. […] The most common cause of a secondary cough headache is a Chiari type I malformation, or abnormality in the skull structure where the lower part of the brain may emerge from the base of the skull and rest in the upper spinal area. Other causes of a secondary cough headache include brain tumors, fluid in the brain, or low cerebrospinal fluid.
- #32 Headache associated with cough: a review | The Journal of Headache and Pain | Full Texthttps://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-42
The pathophysiology of primary cough headache is not well understood, but various hypotheses have been formulated. It seems likely that it is associated with an increased intracranial pressure caused by coughing, this due to an increase in the intra-thoracic and intra-abdominal pressure subsequently leading to an increase in the central venous pressure. […] An increase in intracranial pressure is also believed to be the underlying mechanism of symptomatic cough headache, although the exact mechanism is unknown. In patients with a Chiari malformation type I, this seems to be caused by the sagging of the cerebellar tonsils below the foramen magnum.
- #33 Cough Headache – what causes this rare headache?https://www.severe-headache-expert.com/cough-headache/
The mechanism of headache brought on by coughing is not known for certain. […] A cough causes a rise in pressure inside the head. This pressure rise worsens the Chiari Malformation, by forcing the cerebellar tonsils further into the spinal canal. […] The sudden rise in intracranial pressure (Intra = inside, cranial = head) is what causes the sudden pain.
- #34 Cough headaches – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/primary-cough-headaches/symptoms-causes/syc-20371200
Secondary cough headaches may be caused by: A defect in the shape of the skull. A defect in the part of the brain that controls balance (cerebellum). This can happen when part of the brain is forced through the opening at the base of the skull (foramen magnum), where only the spinal cord should 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. […] Sometimes, what is first diagnosed as a cough headache may be caused by a cerebrospinal fluid (CSF) leak. Coughing or straining may trigger the headache, but the underlying cause is the cerebrospinal fluid (CSF) leak. This is one of the reasons why it’s important to see your provider for a new cough headache.
- #35 Cough Headache: Causes, Symptoms, Treatment & Typeshttps://my.clevelandclinic.org/health/diseases/21071-cough-headache
A cough headache happens suddenly after: Coughing. Sneezing. Blowing your nose. Straining (like during a bowel movement or lifting weights). Laughing. Crying. […] The exact cause of a primary cough headache isn’t well understood. Experts think coughing raises the pressure inside your chest and abdomen (belly), which increases the pressure in your brain. […] Most causes of a secondary cough headache happen due to a growth abnormality in your brain. One of the most common is Chiari malformation type I. This occurs when brain tissue in the lower back part of your skull extends into your spinal canal (the base of your skull). It’s the area of your brain that regulates your balance. […] Other causes of a secondary cough headache include: Brain tumors. Low cerebrospinal fluid (CSF) pressure. Cerebrospinal fluid leak. A buildup of excess CSF in your brain (hydrocephalus). Brain blood vessel weakness (cerebral aneurysm). Blood collecting outside of brain tissue (subdural hematoma).
- #36 Head Hurts When I Cough: Causes, Home Remedies, and Morehttps://www.healthline.com/health/head-hurts-when-i-cough
Secondary headaches can indicate a more serious, underlying condition. These include: Chiari malformation, brain tumor, cerebral (brain) aneurysm, changes in the pressure in the cerebrospinal fluid. […] If you have a Chiari malformation, you may need surgery to create more space for the cerebellum and reduce pressure on the brain. If you have a brain tumor, the type of tumor you have will determine your treatment. If you have a brain aneurysm, you may require surgery, endovascular interventions, or a stent-like implant, called a flow-diverter. If you have a cerebrospinal fluid leak, you’ll need surgery to fix it. […] Secondary cough headaches may respond temporarily to at-home treatments, but their root cause must be addressed in order to eliminate the problem.
- #37 Headache associated with cough: a review | The Journal of Headache and Pain | Full Texthttps://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-42
Cough headache can be further subdivided into primary and symptomatic cough headache. […] Underlying etiologies are present in approximately 40% of the cases and are mostly related to Chiari type I malformation. In general, patients with symptomatic cough headache differ from patients with primary cough headache in the fact that they tend to have more associated symptoms, depending on the underlying abnormality. Additional headache triggers, higher pain intensities and diverse headache durations and locations are generally reported. The major causes of symptomatic cough headache are shown in Figure1. The most common causes are, after Chiari type I malformation, miscellaneous posterior fossa lesions. Other causes include obstructive hydrocephalus and spontaneous low cerebrospinal fluid pressure (CSF).
- #38 Cough Headache: Causes & Treatment | K Health Apphttps://khealth.com/learn/headache/cough-caused-headache/
In most cases, secondary cough headaches are caused by structural problems in a person’s brain. One of the most common causes of a secondary cough headache is Chiari malformation type I, which is a defect involving the part of the brain that deals with balance. […] Some other common causes of secondary cough headache include: A cerebral aneurysm, which causes weakness in one of brain’s blood vessels, A brain tumor, A defect in the shape of the skull, A spontaneous leak of cerebrospinal fluid (CSF), Low cerebrospinal fluid levels, A subdural hematoma, a collection of blood outside the brain’s tissue.
- #39 Cough Headache – what causes this rare headache?https://www.severe-headache-expert.com/cough-headache/
Cough headache is a provoked headache when coughing causes a sudden intense sharp pain. A cough headache is often in the top or back of the head, but any part of the head can be affected. […] There needs to be no pain before the cough, and pain is only induced by the action of coughing. […] Strictly speaking, cough headache only occurs as a result of a cough stimulus. However, it is also known that stooping, sneezing or lifting can produce the pain. […] Just like other exercise induced headaches, there is a 10-20% chance that there is a structural problem in the head causing this headache. […] Causes of cough induced headache include: Chiari Malformation The most commonly identified cause, Meningioma which can be in the posterior fossa, Pituitary Tumour, Subdural Haematoma beware that subdural effusions can be associated with intracranial hypotension, Pneumocephalus, Brainstem compression from platybasia, Other Brain Tumour this is rare, Intracranial Hypotension low CSF pressure due to a spinal fluid leak, Cervicogenic Headache people with pain originating from upper cervical spine joints will describe pain that is made worse or brought on by coughing, Paranasal Sinusitis.
- #40 Diagnosing Secondary Headacheshttps://practicalneurology.com/articles/2020-may/diagnosing-secondary-headaches
Secondary headaches are those in which the headache is a symptom of another disorder recognized as a potential underlying cause. The ICHD-3 provides a list of 8 categories and 46 subcategories for causes of secondary headaches including trauma or injury to the head and neck; cranial and cervical vascular disorders; nonvascular intracranial disorders; a substance or its withdrawal; infection; disorders of homeostasis; disorders of the cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cervical structure; and psychiatric disorders. Approximately 18% of people who experience a headache have a secondary headache disorder. […] Consider neuroimaging when headaches are provoked by coughing, straining, or other Valsalva maneuvers. Secondary cough headache accounts for 40% of all cough headache cases, and therefore a diagnosis of primary cough headache can only be given after secondary causes have been ruled out. The most common cause of cough headache is Chiari malformation type 1. […] Other causes of cough headache include meningiomas, brain metastases, arachnoid cysts, subdural hematoma, intracranial hypertension or hypotension, infection, hydrocephalus, and vascular diseases such as RCVS.
- #41 Headache associated with cough: a review | The Journal of Headache and Pain | Full Texthttps://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-42
The pathophysiology of primary cough headache is not well understood, but various hypotheses have been formulated. It seems likely that it is associated with an increased intracranial pressure caused by coughing, this due to an increase in the intra-thoracic and intra-abdominal pressure subsequently leading to an increase in the central venous pressure. […] An increase in intracranial pressure is also believed to be the underlying mechanism of symptomatic cough headache, although the exact mechanism is unknown. In patients with a Chiari malformation type I, this seems to be caused by the sagging of the cerebellar tonsils below the foramen magnum.
- #42 Modified Valsalva test differentiates primary from secondary cough headache | The Journal of Headache and Pain | Full Texthttps://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-31
The current definition of cough headache includes provocation of the symptom by Valsalva manoeuvre, and it is generally believed that all cough headache results from a sudden increase in intracranial pressure. […] These findings suggest that secondary cough headache results from a transient increase in intracranial CSF pressure during exertion in the presence of obstruction to normal cerebrospinal fluid dynamics. […] Primary cough headache appears to be caused by a different mechanism, possibly through congestion of the orbital venous plexus in the presence of jugular venous incompetence and a reduced threshold for trigeminal sensory activation. […] It is generally believed that all cough headache is caused by a sudden increase in intracranial pressure resulting from exertion. […] However, this mechanism does not accord with our observation that PCH is not provoked by a maximal voluntary Valsalva manoeuvre.
- #43 Primary cough headache | MedLink Neurologyhttps://www.medlink.com/articles/primary-cough-headache
Williams measured CSF pressures from the lumbar region and the cisterna magna in 16 patients while coughing in the sitting position. […] Williams commented that the upward passage of fluid was relatively easy but that the downward rebound from the head towards the spine might cause tissue to jam in the foramen magnum. […] In an attempt to clarify the etiology of cough headache in patients with Chiari I malformations, Sansur and colleagues studied 30 patients with Chiari I malformations and 15 healthy adults. […] The authors hypothesized that headache linked to coughing in patients with Chiari I malformations was associated with a sudden increase in intrathecal pressure caused by obstruction to the free flow of CSF in the subarachnoid space. […] The etiology of benign cough headache was best summed up by Symonds himself, who in 1970 wrote, as far as I am aware its origin remains a mystery.
- #44 Cough headaches – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/primary-cough-headaches/symptoms-causes/syc-20371200
Secondary cough headaches may be caused by: A defect in the shape of the skull. A defect in the part of the brain that controls balance (cerebellum). This can happen when part of the brain is forced through the opening at the base of the skull (foramen magnum), where only the spinal cord should 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. […] Sometimes, what is first diagnosed as a cough headache may be caused by a cerebrospinal fluid (CSF) leak. Coughing or straining may trigger the headache, but the underlying cause is the cerebrospinal fluid (CSF) leak. This is one of the reasons why it’s important to see your provider for a new cough headache.
- #45 Health Information Library | Rumah Sakit Pusat Pertaminahttps://rspp.co.id/dcontent.html?id=CON-20371185&n=Cough%20headaches
- #46 Head Hurts When I Cough: Causes, Home Remedies, and Morehttps://www.healthline.com/health/head-hurts-when-i-cough
Secondary headaches can indicate a more serious, underlying condition. These include: Chiari malformation, brain tumor, cerebral (brain) aneurysm, changes in the pressure in the cerebrospinal fluid. […] If you have a Chiari malformation, you may need surgery to create more space for the cerebellum and reduce pressure on the brain. If you have a brain tumor, the type of tumor you have will determine your treatment. If you have a brain aneurysm, you may require surgery, endovascular interventions, or a stent-like implant, called a flow-diverter. If you have a cerebrospinal fluid leak, you’ll need surgery to fix it. […] Secondary cough headaches may respond temporarily to at-home treatments, but their root cause must be addressed in order to eliminate the problem.
- #47 Cough headaches – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/primary-cough-headaches/symptoms-causes/syc-20371200
Secondary cough headaches may be caused by: A defect in the shape of the skull. A defect in the part of the brain that controls balance (cerebellum). This can happen when part of the brain is forced through the opening at the base of the skull (foramen magnum), where only the spinal cord should 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. […] Sometimes, what is first diagnosed as a cough headache may be caused by a cerebrospinal fluid (CSF) leak. Coughing or straining may trigger the headache, but the underlying cause is the cerebrospinal fluid (CSF) leak. This is one of the reasons why it’s important to see your provider for a new cough headache.
- #48 Cough Headaches in EDS/HSD: Types, Causes, and Management | ActifyPThttps://www.actifypt.com/post/cough-headaches-eds-hsd
Cough headaches are a type of headache caused by coughing and other types of muscular straining, such as sneezing, laughing, crying, singing, or even bending over. […] Doctors have divided cough headaches into two different categories: primary and secondary. Primary cough headaches are often harmless and are improved on their own. But secondary cough headaches, also called symptomatic cough headaches, can be more serious, and can be caused by other problems associated with EDS/HSD. […] For those with EDS/HSD, it has been observed that secondary coughing headaches are often caused by upper cervical instability (instability in the neck) and lower cervical instability (instability in the lower neck/upper back). […] For those with joint instability, it has been found that almost half of cough headaches are secondary to Chiari I Malformation, especially when present in young people and the pain is located near the base of the skull.
- #49 Cough Headaches in EDS/HSD: Types, Causes, and Management | ActifyPThttps://www.actifypt.com/post/cough-headaches-eds-hsd
Cough headaches are a type of headache caused by coughing and other types of muscular straining, such as sneezing, laughing, crying, singing, or even bending over. […] Doctors have divided cough headaches into two different categories: primary and secondary. Primary cough headaches are often harmless and are improved on their own. But secondary cough headaches, also called symptomatic cough headaches, can be more serious, and can be caused by other problems associated with EDS/HSD. […] For those with EDS/HSD, it has been observed that secondary coughing headaches are often caused by upper cervical instability (instability in the neck) and lower cervical instability (instability in the lower neck/upper back). […] For those with joint instability, it has been found that almost half of cough headaches are secondary to Chiari I Malformation, especially when present in young people and the pain is located near the base of the skull.
- #50 Cough Headaches in EDS/HSD: Types, Causes, and Management | ActifyPThttps://www.actifypt.com/post/cough-headaches-eds-hsd
Cough headaches are a type of headache caused by coughing and other types of muscular straining, such as sneezing, laughing, crying, singing, or even bending over. […] Doctors have divided cough headaches into two different categories: primary and secondary. Primary cough headaches are often harmless and are improved on their own. But secondary cough headaches, also called symptomatic cough headaches, can be more serious, and can be caused by other problems associated with EDS/HSD. […] For those with EDS/HSD, it has been observed that secondary coughing headaches are often caused by upper cervical instability (instability in the neck) and lower cervical instability (instability in the lower neck/upper back). […] For those with joint instability, it has been found that almost half of cough headaches are secondary to Chiari I Malformation, especially when present in young people and the pain is located near the base of the skull.
- #51 Cough Headaches in EDS/HSD: Types, Causes, and Management | ActifyPThttps://www.actifypt.com/post/cough-headaches-eds-hsd
Chiari I Malformation is still just one of a few causes for those with instability to experience cough headaches. In addition, changes in cerebrospinal fluid circulation can also contribute to cough headaches, which is also associated with dizziness, headache, vision problems such as sensitivity to light, tinnitus, and tremors.
- #52 Cough headacheshttps://www.mymlc.com/health-information/diseases-and-conditions/c/cough-headaches2/?section=Diagnosis
Cough headaches are an unusual type of headache triggered by coughing and other types of straining â 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, also called symptomatic cough headaches, are more serious, as they can be caused by problems within the brain. Treatment of secondary cough headaches may require surgery. […] The cause of primary cough headaches is unknown. […] 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 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. […] Risk factors for secondary cough headaches include: Being younger than age 40.
- #53 Cough headacheshttps://www.mymlc.com/health-information/diseases-and-conditions/c/cough-headaches2/?section=Diagnosis
Cough headaches are an unusual type of headache triggered by coughing and other types of straining â 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, also called symptomatic cough headaches, are more serious, as they can be caused by problems within the brain. Treatment of secondary cough headaches may require surgery. […] The cause of primary cough headaches is unknown. […] 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 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. […] Risk factors for secondary cough headaches include: Being younger than age 40.
- #54 Cough headacheshttps://www.mymlc.com/health-information/diseases-and-conditions/c/cough-headaches2/?section=Diagnosis
Cough headaches are an unusual type of headache triggered by coughing and other types of straining â 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, also called symptomatic cough headaches, are more serious, as they can be caused by problems within the brain. Treatment of secondary cough headaches may require surgery. […] The cause of primary cough headaches is unknown. […] 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 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. […] Risk factors for secondary cough headaches include: Being younger than age 40.
- #55 Cough headacheshttps://www.mymlc.com/health-information/diseases-and-conditions/c/cough-headaches2/?section=Diagnosis
Cough headaches are an unusual type of headache triggered by coughing and other types of straining â 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, also called symptomatic cough headaches, are more serious, as they can be caused by problems within the brain. Treatment of secondary cough headaches may require surgery. […] The cause of primary cough headaches is unknown. […] 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 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. […] Risk factors for secondary cough headaches include: Being younger than age 40.
- #56 Why Does My Head Hurt When I Cough? – Healthcare Associates of Texashttps://healthcareassociates.com/why-does-my-head-hurt-when-i-cough/
Coughing can cause headaches that are typically known as „cough headaches.” A cough headache is usually caused by straining in some other way while you are coughing. […] A primary cough headache is caused by the cough itself, and not by another health problem. […] A secondary cough headache is far more serious than a primary cough headache. […] The exact cause of a primary cough headache is not well understood by doctors and researchers. Some doctors think that coughing increases pressure in the chest and stomach, which may then lead to increased pressure in the brain. […] A secondary cough headache may be triggered by one of several causes. These causes include: an abnormal or defective skull shape, a defective cerebellum, a weakened blood vessel in the brain, a brain tumor, and spontaneous leaking of the liquid around your brain and spinal cord. […] Certain risk factors may increase your likelihood of developing a primary cough headache or a secondary cough headache. You may be at risk for getting a primary cough headache if you are a male or over the age of 40. The main risk factor for a secondary cough headache is being under the age of 40.
- #57https://continentalhospitals.com/diseases/cough-headaches/
Risk factors for cough headaches, also known as exertional headaches, include: Age: Cough headaches are more common in individuals over the age of 40. Sex: Men are more likely to experience cough headaches than women. Medical Conditions: Certain medical conditions such as Chiari malformation, a structural defect in the base of the skull, and other disorders affecting the brain or spinal cord can increase the risk of cough headaches. Family History: A family history of cough headaches or other types of primary headaches may predispose individuals to experiencing them. Physical Activity: Activities that involve sudden changes in intracranial pressure, such as coughing, sneezing, or straining during bowel movements, can trigger cough headaches. Lifestyle Factors: Smoking, obesity, and a sedentary lifestyle may also contribute to the risk of developing cough headaches. Medications: Certain medications, such as those used to treat high blood pressure, can potentially trigger or exacerbate cough headaches. Underlying Conditions: People with underlying conditions such as migraine or tension headaches may be more prone to experiencing cough headaches. Genetics: There may be a genetic predisposition to cough headaches, although more research is needed to fully understand this aspect.
- #58https://continentalhospitals.com/diseases/cough-headaches/
Risk factors for cough headaches, also known as exertional headaches, include: Age: Cough headaches are more common in individuals over the age of 40. Sex: Men are more likely to experience cough headaches than women. Medical Conditions: Certain medical conditions such as Chiari malformation, a structural defect in the base of the skull, and other disorders affecting the brain or spinal cord can increase the risk of cough headaches. Family History: A family history of cough headaches or other types of primary headaches may predispose individuals to experiencing them. Physical Activity: Activities that involve sudden changes in intracranial pressure, such as coughing, sneezing, or straining during bowel movements, can trigger cough headaches. Lifestyle Factors: Smoking, obesity, and a sedentary lifestyle may also contribute to the risk of developing cough headaches. Medications: Certain medications, such as those used to treat high blood pressure, can potentially trigger or exacerbate cough headaches. Underlying Conditions: People with underlying conditions such as migraine or tension headaches may be more prone to experiencing cough headaches. Genetics: There may be a genetic predisposition to cough headaches, although more research is needed to fully understand this aspect.
- #59https://continentalhospitals.com/diseases/cough-headaches/
Risk factors for cough headaches, also known as exertional headaches, include: Age: Cough headaches are more common in individuals over the age of 40. Sex: Men are more likely to experience cough headaches than women. Medical Conditions: Certain medical conditions such as Chiari malformation, a structural defect in the base of the skull, and other disorders affecting the brain or spinal cord can increase the risk of cough headaches. Family History: A family history of cough headaches or other types of primary headaches may predispose individuals to experiencing them. Physical Activity: Activities that involve sudden changes in intracranial pressure, such as coughing, sneezing, or straining during bowel movements, can trigger cough headaches. Lifestyle Factors: Smoking, obesity, and a sedentary lifestyle may also contribute to the risk of developing cough headaches. Medications: Certain medications, such as those used to treat high blood pressure, can potentially trigger or exacerbate cough headaches. Underlying Conditions: People with underlying conditions such as migraine or tension headaches may be more prone to experiencing cough headaches. Genetics: There may be a genetic predisposition to cough headaches, although more research is needed to fully understand this aspect.
- #60 Headache associated with cough: a review | The Journal of Headache and Pain | Full Texthttps://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-42
Headache only triggered by coughing is a rather uncommon condition. The aim of the present review is to present an overview of the diagnosis, clinical characteristics, pathophysiology and treatment of both primary and symptomatic cough headache and discuss other relevant headache disorders affected by coughing. The diagnosis of primary cough headache is made when headache is brought on and occurs only in association with coughing, straining or a Valsalva manoeuvre and in the absence of any abnormalities on neuro-imaging. In case an underlying pathology is identified as a cause of the headache, the diagnosis of symptomatic cough headache is made. The vast majority of these patients present with a Chiari malformation type I. Other frequently reported causes include miscellaneous posterior fossa pathology, carotid or vertebrobasilar disease and cerebral aneurysms. Consequently, diagnostic neuroimaging is key in the diagnosis of cough-related headache and guides treatment.
- #61 Headache associated with cough: a review | The Journal of Headache and Pain | Full Texthttps://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-42
The pathophysiology of primary cough headache is not well understood, but various hypotheses have been formulated. It seems likely that it is associated with an increased intracranial pressure caused by coughing, this due to an increase in the intra-thoracic and intra-abdominal pressure subsequently leading to an increase in the central venous pressure. […] An increase in intracranial pressure is also believed to be the underlying mechanism of symptomatic cough headache, although the exact mechanism is unknown. In patients with a Chiari malformation type I, this seems to be caused by the sagging of the cerebellar tonsils below the foramen magnum.
- #62 Cough Headache: Causes, Symptoms, Treatment & Typeshttps://my.clevelandclinic.org/health/diseases/21071-cough-headache
A cough headache happens suddenly after: Coughing. Sneezing. Blowing your nose. Straining (like during a bowel movement or lifting weights). Laughing. Crying. […] The exact cause of a primary cough headache isn’t well understood. Experts think coughing raises the pressure inside your chest and abdomen (belly), which increases the pressure in your brain. […] Most causes of a secondary cough headache happen due to a growth abnormality in your brain. One of the most common is Chiari malformation type I. This occurs when brain tissue in the lower back part of your skull extends into your spinal canal (the base of your skull). It’s the area of your brain that regulates your balance. […] Other causes of a secondary cough headache include: Brain tumors. Low cerebrospinal fluid (CSF) pressure. Cerebrospinal fluid leak. A buildup of excess CSF in your brain (hydrocephalus). Brain blood vessel weakness (cerebral aneurysm). Blood collecting outside of brain tissue (subdural hematoma).
- #63 Headache associated with cough: a review | The Journal of Headache and Pain | Full Texthttps://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-42
Cough headache can be further subdivided into primary and symptomatic cough headache. […] Underlying etiologies are present in approximately 40% of the cases and are mostly related to Chiari type I malformation. In general, patients with symptomatic cough headache differ from patients with primary cough headache in the fact that they tend to have more associated symptoms, depending on the underlying abnormality. Additional headache triggers, higher pain intensities and diverse headache durations and locations are generally reported. The major causes of symptomatic cough headache are shown in Figure1. The most common causes are, after Chiari type I malformation, miscellaneous posterior fossa lesions. Other causes include obstructive hydrocephalus and spontaneous low cerebrospinal fluid pressure (CSF).
- #64 Headache associated with cough: a review | The Journal of Headache and Pain | Full Texthttps://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-42
Headache only triggered by coughing is a rather uncommon condition. The aim of the present review is to present an overview of the diagnosis, clinical characteristics, pathophysiology and treatment of both primary and symptomatic cough headache and discuss other relevant headache disorders affected by coughing. The diagnosis of primary cough headache is made when headache is brought on and occurs only in association with coughing, straining or a Valsalva manoeuvre and in the absence of any abnormalities on neuro-imaging. In case an underlying pathology is identified as a cause of the headache, the diagnosis of symptomatic cough headache is made. The vast majority of these patients present with a Chiari malformation type I. Other frequently reported causes include miscellaneous posterior fossa pathology, carotid or vertebrobasilar disease and cerebral aneurysms. Consequently, diagnostic neuroimaging is key in the diagnosis of cough-related headache and guides treatment.
- #65 Diagnosing Secondary Headacheshttps://practicalneurology.com/articles/2020-may/diagnosing-secondary-headaches
Secondary headaches are those in which the headache is a symptom of another disorder recognized as a potential underlying cause. The ICHD-3 provides a list of 8 categories and 46 subcategories for causes of secondary headaches including trauma or injury to the head and neck; cranial and cervical vascular disorders; nonvascular intracranial disorders; a substance or its withdrawal; infection; disorders of homeostasis; disorders of the cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cervical structure; and psychiatric disorders. Approximately 18% of people who experience a headache have a secondary headache disorder. […] Consider neuroimaging when headaches are provoked by coughing, straining, or other Valsalva maneuvers. Secondary cough headache accounts for 40% of all cough headache cases, and therefore a diagnosis of primary cough headache can only be given after secondary causes have been ruled out. The most common cause of cough headache is Chiari malformation type 1. […] Other causes of cough headache include meningiomas, brain metastases, arachnoid cysts, subdural hematoma, intracranial hypertension or hypotension, infection, hydrocephalus, and vascular diseases such as RCVS.