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Primary cough headache, primary exertional headache, and primary headache associated with sexual activity: a clinical and radiological study

  • Diagnostic Neuroradiology
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Abstract

Introduction

The purposes of this study are to describe clinical features of primary cough headache, primary exertional headache, and primary headache associated with sexual activity and to evaluate potential association with abnormalities in the cerebral or cervical venous circulation.

Methods

This multicentre, observational, non-interventional consecutive cohort study included patients fulfilling ICHD-II criteria for primary cough headache (N = 10), primary exertional headache (N = 11), or primary headache associated with sexual activity (N = 20), as well as 16 headache-free controls. Each patient was evaluated clinically and underwent craniocervical MRV of the cranial circulation. All scans were interpreted centrally by blinded raters, using the Farb criteria proposed for idiopathic intracranial hypertension. Stenosis was defined as a Farb score <3 in left or right transverse sinuses or jugular veins.

Results

In all primary headache groups, headaches were most frequently diffuse, severe, or very severe. Headache duration was significantly shorter in patients with cough headache (median 6.5 versus 20 and 60 min). An exploitable magnetic resonance venogram was obtained for 36 patients. Stenosis was detected in none of the control group, but in 5/7 patients with primary cough headache group, 2/10 patients with primary exertion headache, and 12/19 patients with primary headache associated with sexual activity. The frequency of stenosis was significantly different from the control group in the primary cough headache and primary headache associated with sexual activity groups.

Conclusions

Headaches provoked by cough and sexual activity are possibly associated with venous abnormalities in a significant subgroup of affected patients. As the literature shows conflicting results, this venous stenosis can be considered as a promoting factor.

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Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Service de Neurologie et Pathologie du Mouvement, Pole Neurosciences Cliniques, Hôpital Timone, 264 Boulevard Saint-Pierre, 13385, Marseille Cedex 05, France

    Anne Donnet

  2. INSERM/UdA, U1107, Neuro-Dol, Clermont-Ferrand, France

    Anne Donnet & Michel Lanteri-Minet

  3. Centre Urgences Céphalées, Hôpital Lariboisière, Paris, France

    Dominique Valade

  4. Service de Neuroradiologie, Hôpital Lariboisière, Paris, France

    Emmanuel Houdart

  5. Département d’Evaluation et Traitement de la Douleur, Pole Neurosciences Cliniques, Hôpital Cimiez, Nice, France

    Michel Lanteri-Minet

  6. Service de Neuroradiologie, Hôpital Pasteur, Nice, France

    Charles Raffaelli

  7. Service de Neurologie, Hôpital Croix Rousse, Lyon, France

    Geneviève Demarquay

  8. Service de Neuroradiologie, Hôpital Neurologie, Lyon, France

    Marc Hermier

  9. Service de Neurologie, Hôpital Charles Nicole, Rouen, France

    Evelyne Guegan-Massardier

  10. Service de Neuroradiologie, Hôpital Charles Nicole, Rouen, France

    Emmanuel Gerardin

  11. Service de Neurologie, Hôpital Rangueil, Toulouse, France

    Gilles Geraud

  12. Service de Neuroradiologie, Hôpital Purpan, Toulouse, France

    Christophe Cognard

  13. Service de Neuroradiologie, Hôpital Timone, Marseille, France

    Olivier Levrier & Pierre Lehmann

Authors
  1. Anne Donnet
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  2. Dominique Valade
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  3. Emmanuel Houdart
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  4. Michel Lanteri-Minet
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  5. Charles Raffaelli
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  6. Geneviève Demarquay
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  7. Marc Hermier
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  8. Evelyne Guegan-Massardier
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  9. Emmanuel Gerardin
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  10. Gilles Geraud
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  11. Christophe Cognard
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  12. Olivier Levrier
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  13. Pierre Lehmann
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Corresponding author

Correspondence to Anne Donnet.

Additional information

This study was initiated by the Société Française d’Etudes des Migraines et Céphalées (SFEMC: French Society for the Study of Migraine and Headache)

Electronic supplementary material

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Supplementary Table 1

Magnetic resonance imaging protocols used for venography (DOC 33 kb)

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Donnet, A., Valade, D., Houdart, E. et al. Primary cough headache, primary exertional headache, and primary headache associated with sexual activity: a clinical and radiological study. Neuroradiology 55, 297–305 (2013). https://doi.org/10.1007/s00234-012-1110-0

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  • DOI: https://doi.org/10.1007/s00234-012-1110-0

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