Cough headache secondary to spontaneous intracranial hypotension complicated by cerebral venous thrombosis

Abstract

Cough headache may be the clinical manifestation, sometimes isolated, of an intracranial disease. There are several possible causes of secondary cough headache. The hypothesis that cough headache may be the expression of spontaneous intracranial hypotension has been advanced only recently. In fact, this would represent an exception to the rule that cough headache is generally secondary to conditions leading to an increase in intracranial pressure and/or volume. We report and discuss a case of cough headache secondary to spontaneous intracranial hypotension in an otherwise healthy 59-year-old man. The condition was complicated by cerebral venous thrombosis.

Post-caesarean Section Headache: A Case Report of Post-dural Puncture Headache and Cerebral Venous Thrombosis Following Epidural Anaesthesia

“…The venous engorgement leads to the appearance of a thickened dura and the dilation of cerebral veins and sinuses, resulting in a decrease in blood flow velocity. Studies using transcranial Doppler ultrasound have shown that blood flow velocities in the sagittal venous sinus decrease by about 47% post-lumbar puncture (LP) [ 22 , 23 ].…”

Treatment of postural headache occurred 26 days after spinal pain procedure - A case report -

“…In this case, because he developed a headache 26 days later, we hypothesized the following: At the time of the procedure, a small hole was created when the needle grazed the dura, where the CSF leak may have become severe enough to cause hypotension for 26 days. Another possibility is that the part of the dura that was weakened by needle grazing was torn by a minor event that increased the CSF pressure, such as coughing or sneezing [ 13 ]. Therefore, based on the patient's symptoms, MRI findings, and history of spinal pain procedure, our impression of the patient's headache was secondary intracranial hypotension, which was considered highly correlated with the pain intervention.…”

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“…Rarely they may present with headache that is non-postural [18,19] paradoxically caused by lying down [20] or intermittently triggered by coitus [9], cough [21], head movements [22] or various forms of exertion [23]. The headache may be associated with nausea or emesis, neck stiffness and cochlear-vestibular signs commonly [2,5,[24][25][26] or with facial numbness, pain or weakness and dysgeusia less commonly [27].…”