Ocular Compression Maneuver Aborts Benign Cough-Induced Headache


  • Vinod Kumar Gupta MD

  • From the Dubai Police Medical Services, Dubai, United Arab Emirates.

Address all correspondence to Dr. Vinod Kumar Gupta, MD, Physician, Dubai Police Medical Service, P.O. Box 12005, Dubai, United Arab Emirates.


Benign cough-induced headache is a short-lasting cranial discomfort. The therapeutic role of lumbar puncture (LP) or indomethacin in benign patients with benign cough-induced headache patients is debatable. Transient ocular compression (OC) raises intraocular pressure (IOP) and can limit the impact of cough-induced choroidal venous congestion. A self-applied maneuver that instantaneously aborts cough-induced headache is described in two patients. The effect of this maneuver supports a recent hypothesis that cough-induced headache may be due to ocular choroidal venous congestion and mechanical antidromic trigeminal nerve activation. The OC maneuver has several potential complications and its self-application in benign cough-induced headache should be regarded as an experimental procedure until more data regarding its efficacy and safety become available.