Headache Clinic, Department of Neurology, Universitair Ziekenhuis Brussel, Brussel, Belgium.
J Headache Pain. 2013 May 20;14(1):42. doi: 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. Besides primary and symptomatic cough headache, several other both primary and secondary headache disorders exist where coughing acts as a trigger or aggravator of headache symptomatology.
仅由咳嗽引发的头痛是一种相当罕见的情况。本综述的目的是概述原发性和症状性咳嗽性头痛的诊断、临床特征、病理生理学和治疗，并讨论其他受咳嗽影响的相关头痛障碍。原发性咳嗽性头痛的诊断是在头痛发作且仅与咳嗽、用力或瓦氏动作相关，并且神经影像学检查无任何异常时做出的。如果确定潜在病理是头痛的原因，则做出症状性咳嗽性头痛的诊断。这些患者绝大多数表现为 Chiari 畸形 I 型。其他常报告的原因包括各种后颅窝病变、颈动脉或椎基底动脉疾病和脑动脉瘤。因此，诊断性神经影像学检查是诊断与咳嗽相关的头痛的关键，并指导治疗。除了原发性和症状性咳嗽性头痛外，还有一些其他原发性和继发性头痛障碍，其中咳嗽是头痛症状的触发或加重因素。
