COUGH, EXERTIONAL, AND SEXUAL HEADACHES - AN ANALYSIS OF 72 BENIGN AND SYMPTOMATIC CASES

We analyzed our experience with cough, exertional, and vascular sexual headaches, evaluated the interrelationships among them, and examined the possible symptomatic cases. Seventy-two patients consulted us beca use of headaches precipitated by coughing (n = 30), physical exercise (n = 28), or sexual excitement (n = 14). Thirty (42%) were symptomatic . The 17 cases of symptomatic cough headache were secondary to Chiari type I malformation, while the majority of cases of symptomatic exerti onal headaches and the only case of symptomatic sexual headache were s econdary to subarachnoid hemorrhage. Although the precipitant was the san-ie, benign and symptomatic headaches differed in several clinical aspects, such as age al onset, associated clinical manifestations, or response to pharmacologic treatment. Although sharing some properties, such as male predominance, benign cough headache and benign exertiona l headache are clinically separate conditions. Benign cough headache b egan significantly later, 43 years on average, than benigns exertional headache. By contrast, our findings suggest that there is a close rel ationship between benign exertional headache and benign vascular sexua l headache. We conclude that benign and symptomatic cough headaches ar e different om both benign and symptomatic exertional and sexual heada ches.