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Cough headache due to craniospinal pressure dissociation
Archives of Neurology
|April 1, 1980
Summary
Coughing or straining can cause severe headaches due to pressure differences in the brain. Decompressing cerebellar tonsils relieved these symptoms, suggesting a link between tonsil position and headache.
Area of Science:
- Neurology
- Neurosurgery
- Cerebrospinal Fluid Dynamics
Background:
- Cough headaches are a rare type of headache often associated with structural abnormalities at the foramen magnum.
- Understanding the pathophysiology of exertional headaches is crucial for effective diagnosis and treatment.
Observation:
- Two female patients presented with acute, severe headaches triggered by straining or coughing.
- Headaches were brief, lasting approximately one minute, and occurred seconds after the inciting event.
Findings:
- Cranial pressure studies revealed a significant pressure gradient between the ventricles and the lumbar subarachnoid space following coughing or straining.
- This craniospinal pressure dissociation normalized after surgical decompression.
Implications:
- Cerebellar tonsillar decompression is an effective treatment for headaches caused by craniospinal pressure dissociation.
- The findings highlight the importance of cerebellar tonsil position in regulating intracranial pressure during Valsalva maneuvers.