Cough Headache Presenting with Reversible Cerebral Vasoconstriction Syndrome

Area of Science:

• Neurology
• Neurosurgery
• Vascular Neurology

Background:

• Cough headache is typically a benign primary headache disorder.
• However, it can also be a secondary symptom of serious underlying neurological conditions.
• Reversible cerebral vasoconstriction syndrome (RCVS) is a condition characterized by temporary narrowing of brain arteries.

Observation:

• A 52-year-old woman presented with cough headache.
• Her presentation was diagnosed as reversible cerebral vasoconstriction syndrome (RCVS).
• This occurred despite the absence of thunderclap headache or focal neurological deficits.

Findings:

• Cough headache can be an initial presentation of RCVS.
• RCVS can be triggered by activities causing intracranial pressure surges, potentially involving aberrant sympathetic responses.
• The diagnostic criteria for RCVS may need to encompass presentations like isolated cough headache.

Implications:

• Clinicians should consider RCVS in patients presenting with cough headache, even without classic RCVS symptoms.
• Early recognition of RCVS is crucial for appropriate management and prevention of complications such as stroke.
• This case expands the known clinical spectrum of RCVS presentations.