Khudheeja Ahmed
Kaaj Healthcare, USATitle: Primary Cough Headache: A Case Report
Abstract
Primary cough headache is an uncommon condition characterized by episodes of sudden
onset, bilateral headaches typically lasting from a second to two hours. Headaches are notably
associated with Valsalva maneuvers such as coughing or straining in the absence of intracranial
abnormalities. We report an unusual presentation of primary cough headache in a 53-year-old
female suffering from episodes of severe sudden onset headaches that lasted several hours. The
headaches were initially precipitated by coughing as is typical of primary cough headaches but
were unusual in that the triggers for the episodes evolved over time. Headaches began occurring
without association to any Valsalva maneuvers and ultimately occurred with no discernible
trigger. The patient was initially prescribed Methylprednisolone, primarily to suppress the cough.
Magnetic resonance imaging (MRI), magnetic resonance angiography (MRA) of the brain, and a
head CT scan were performed to rule out possible secondary causes such as a mass, intracranial
bleed, aneurysms, or other vascular anomalies. The neurologist prescribed Indomethacin and
Topiramate. After five days, the beta blocker Metoprolol Tartrate was prescribed as it was noted
that the blood pressure was rising significantly in correlation to the headaches. The above
treatment was effective in limiting the intensity and duration of the headaches and symptoms
resolved after four weeks. This case contributes towards the understanding of the potential
evolution of primary cough headache presenting with triggers unassociated with Valsalva
maneuvers and ultimately occurring with no known trigger, as well as providing an example of
PCH of an unusually long duration
Biography
Khudheeja Ahmed works at Kaaj Healthcare in the USA.
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