Cough headache: a study of 83 consecutive patients

Authors

  • P-K Chen,

    1. Department of Neurology, Lin-Shin Hospital,
    2. Department of Medical Imaging and Radiological Science, Central Taiwan University of Science and Technology, Taichung,
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  • J-L Fuh,

    1. National Yang-Ming University School of Medicine, and
    2. Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
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  • S-J Wang

    Corresponding author
    1. National Yang-Ming University School of Medicine, and
    2. Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
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Dr Shuu-Jiun Wang MD, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan. Tel. + 886-2-2876-2522, fax + 886-2-2876-5215, e-mail sjwang@vghtpe.gov.tw

Abstract

To delineate the differences in clinical characteristics and evaluate the outcome between primary and secondary cough headache, 83 consecutive patients (59M/24F, mean age 61.5 ± 17.7 years) with cough headache (1.2%) out of 7100 patients in a headache clinic were studied. All of them received brain imaging studies. Most did not have relevant brain lesions (n = 74, 89.2%, primary group) except for nine patients (10.8%, the secondary group). Most of the intracranial lesions were located in the posterior fossa (n = 6, 67%), including only two patients with Chiari malformation. The primary group had a higher response rate to indomethacin than the secondary group (72.7% vs. 37.5 %, P = 0.046). Mild to moderate headache intensity and age onset < 50 years predicted a favourable response. At a mean follow-up of 51.4 months, 83.9% of patients with primary cough headache completely remitted. Inconsistent with the proposed International Classification of Headache Disorders, 2nd edn criteria, 10.8% of patients with primary cough headache had headache duration of > 30 min. Clinical features, neurological examinations and drug response could not safely differentiate primary from secondary cough headache. Neuroimaging studies are required in each patient.

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