[Headache after coughing: consider cough headache].
A 67-year-old male and a 43-year-old female were referred to hospital with headaches after intracranial pressure increasing activities, such as coughing. Both patients were diagnosed with primary cough headache. In the case of the first patient, this diagnosis was considered shortly after presentation. His headache disappeared with the standard treatment for primary cough headache, consisting of indomethacin and a proton pump inhibitor. The second patient received medicinal and surgical treatment for rhinosinusitis. These treatments did not improve the headache symptoms. Eventually she was also diagnosed with primary cough headache, and became pain-free with indomethacin and a proton pump inhibitor. Primary cough headache should be differentiated from secondary cough headache, in which the symptoms are caused by structural abnormalities of the brain. Additional investigation is required to differentiate between the two. The diagnosis of primary cough headache is supported by a positive reaction to trial treatment with indomethacin.
Isala klinieken, afd. Neurologie, Zwolle, The Netherlands.
L G Bert
LG
Nap
J S P Peter
JS
van den Berg
Gosse
G
de Jong
D000328:Adult; D000368:Aged; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D051270:Headache Disorders, Primary / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D008297:Male; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012852:Sinusitis / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
D016861:Cyclooxygenase Inhibitors; D054328:Proton Pump Inhibitors; D007213:Indomethacin