Pearls & Oy-sters: cough headache secondary to Chiari malformation type I

Prevalence and characteristics of cough headache in a Chinese respiratory clinic

BACKGROUND

To evaluate the prevalence, predictive factors and clinical characteristics of cough headache in our respiratory clinic and to investigate the coexistence between cough headache, migraine and tension-type headache.

METHOD

We consecutively investigated patients referred to our respiratory clinic with complaints of cough and selected patients with cough headaches to complete a structured interview and examination.

RESULTS

Six hundred and seventy-nine patients with cough were studied and 122 patients were diagnosed with cough headache. The prevalence of cough headache was 18.0% in these coughing patients. According to multivariate analysis, being of an age between 31-50 years was a risk factor for cough headache (OR 2.0). Cough headache was associated with cough severity: Compared with the mild group, the moderate group (OR 2.3) and the severe group (OR 3.3) were more vulnerable to cough headache. Headache severity had a positive correlation with cough severity (ρ = 0.301, p = 0.028), age (ρ = 0.199, p = 0.029), and headache duration (ρ = 0.242, p = 0.008). In cough headache patients, 30.3% had tension-type headache and 10.7% had migraine in the preceding year.

CONCLUSIONS

Cough headache is not rare in respiratory clinics and the characteristics are somewhat different from those in headache clinics. An age of between 31-50 years and cough severity were risk factors for cough headache. Headache severity was related to cough severity, age and headache duration.