Introduction
Headaches that occur exclusively when coughing are also called cough headaches. A distinction must be made here between a primary and secondary headache. Primary cough headaches are a rare type of headache and are characterized by the fact that they do not occur in the context of other disorders but in isolation.
The situation is different for secondary cough headaches that are caused by an underlying disorder such as a cold. While secondary cough headaches usually subside with the underlying disease, primary cough headaches can last for several months or years. The duration of individual headache attacks after coughing is a few seconds to minutes.
What causes headaches when coughing?
How headaches develop in the context of coughing is now well understood and is largely related to an increase in intracranial pressure. During the coughing process, the abdominal muscles are tensed, which results in an increase in abdominal pressure (in the abdomen). This leads to an increase in the central venous pressure, which is transmitted to the vessels of the head and here in turn leads to an increase in intracranial pressure, resulting in headaches.
However, since this mechanism is present in all people, the question remains as to why some patients react much more sensitively to such an increase in pressure, in the sense of a primary headache, than others. Recent studies have been able to clarify this fact. For example, it has been shown that these patients often have an increased amount of cerebrospinal fluid (liquor) and thus have a fundamentally higher intracranial pressure. If a further increase occurs during coughing, the pain threshold of the cerebral pressure is reached faster in these patients. The causes for the increased volume of cerebrospinal fluid are numerous and range from increased formation to restricted outflow.
How long do cough headaches last?
The duration of cough headaches varies greatly. While the individual attacks last only for a few seconds to minutes, the duration of the disease depends on the underlying cause. If the pain occurs in the context of respiratory tract infections, it usually lasts only until the infection is cured. Primary cough headaches, on the other hand, can last for several years, but then often show spontaneous healing.
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