This disorder affects mostly middle-aged men, and tends to recede with time. The headache is considered to be uncommon. The headache may be reported to begin in association with a lower respiratory infection that is accompanied by coughing. The headache begins moments after the coughing and reaches a peak almost immediately, subsequently subsiding over seconds to minutes. The pain may be followed by dull aching that may persist for hours.
Most patients are painfree between attacks.
This headache is not accompanied by migraine accompaniments such as nausea, photophobia or phonophobia. Migraine and other headache disorders may be intensified by coughing but this headache is elicited by coughing. Since brain tumors and A-C malformation cause cough headache syndrome, an MRI should be obtained in all of these patients to rule these out. If this fails, use of naproxen, methergine and phenelzine should be considered. 4.5 Benign exertional headache Benign exertional headache is precipitated by any form of exercise.