Cough headache

Hello! I have been a doctor for 21 years. My name is Georgy Olegovich Sapego. In this article, I'll tell you something useful about a cough headache.

Sometimes people complain of a headache that is triggered by a cough. This headache is called a cough or Valsalva test headache.

Who is Valsalva

The Valsalva test is a straining test. Try to start exhaling through your mouth and then close your mouth and puff out your cheeks. When you try to exhale and no air comes out, you get a straining test. This sample was named after the Italian anatomist Antonio Maria Valsalva. Make money from school answers to Answers to questions about the school curriculum.

What is the difference

A coughing headache resembles an exercise headache (I have a separate article about it). The only difference is that a headache from physical exertion appears during work, and a cough headache can appear only from straining.

There are signs by which you can distinguish a cough headache from a headache of physical effort:

  • A cough headache is triggered by a Valsalva breakdown, and an effort headache is triggered by exercise.
  • A cough headache is more likely at age 65, and a headache of physical exertion is more likely at 25.
  • A cough headache starts instantly, and a physical effort headache builds up gradually over a few minutes.
  • The cough pain is sharp and constant, and the headache from physical exertion pulses in time with the heartbeat.

A cough headache usually affects people over 40. It is bilateral, strong, begins suddenly and lasts from a few seconds to 30 minutes.

With such a headache, there is no nausea, no vomiting, no hypersensitivity to light or sound.

They say that about 1% of people there ever is such pain.

As with exercise headaches, cough pain may be secondary. That is, there may be some kind of formation in the head, such as a tumor or aneurysm, from which pain appears when straining.

It is said that about half of people with a cough headache may have such causes. A secondary cough headache may last for several days.


For diagnosis, a reaction to indomethacin is sometimes used. Indomethacin is a simple anti-inflammatory drug with a ton of side effects. It is because of its side effects that indomethacin has an unusual effect on cough headaches. It is unclear exactly what he does there, but it seems to reduce intracranial pressure. If indomethacin helps with a cough headache, then this pain is most likely primary, that is, harmless.

It's about cerebrospinal fluid

Experts believe that the mechanism of cough headache is related to the circulation of cerebrospinal fluid. There is such a tricky trick: cerebrospinal fluid easily penetrates from the spine into the skull, but it is more difficult for it to return back. Therefore, when coughing, a kind of water hammer spreads to the head.

The forecast is rather good

The cough headache usually goes away afterwards. True, this sometimes takes several years. It is clear that during this time any bronchitis has to be treated more aggressively than is usually required.

This type of headache occurs with life-threatening illnesses, so be sure to check with your doctor.

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