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Table 1 Response to modified Valsalva test and brain MRI results in 16 patients with ‘cough headache’

From: Modified Valsalva test differentiates primary from secondary cough headache

No Age Sex Location Triggers Immediate preceding history Headache history Valsalva test response MRI brain
1 22 F Holocranial Coughing, lifting, standing from lying None None. MO subsequently + Chiari 1
2 28 M R Frontal Coughing, laughing, sexual intercourse, bening over URTI None ± Normal
3 57 F Holoccanial Coughing, sneezing, bending over, crouching URTI Facial migraine, tension headache, auras - Normal
4 30 F Holocranial, R parietal Standing up from a crouch None MO, exertional headache + Chiari 1
5 32 F Occipital Coughing, laughing, sneezing, bending over None MO + Chiari 1
6 65 M Occipital Coughing, bending over, stooping, lifting, straining at stool None Laughing headache + Chiari 1
7 63 M L Frontal Coughing, bending over URTI MO - Normal
8 87 M Frontal Coughing, sneezing None None - Normal
9 63 F Vertex Coughing, straining, laughing, bending over None MO + Posterior fossa meningioma
10 30 F Occipitonuchal Coughing None MO, thunderclap + Chiari 1
11 36 M Frontal Laughing, bending over, coughing None None + Chiari 1
12 43 F Vertex Coughing, sneezing, lifting None MO, MO with trigeminal autonomic symptoms + Chiari I
13 38 M L fronto-temporal Golf swing, bending over, lifting None MA - Normal
14 62 F R frontal, any area Coughing, bending over, sneezing, straining at stool Cervical manipulation None + ‘Posterior fossa crowdedness’ 1
15 46 F Occipital Coughing, shouting, sneezing, bending over, turning quickly None None + Posterior fossa meningioma
16 32 F Holocranial, frontal Bending over, lifting, blowing up balloons None MO, exercise-triggered migraine + Chiari 1
  1. 10 patients had positive tests and abnormal MRI (8 Chiari 1 malformation, 2 posterior fossa meningiomas. Patient 14 had a positive test with normal MRI but had a high hindbrain to posterior cranial fossa ratio consistent with ‘posterior fossa crowdedness’ [14]. 4 patients had negative tests and one an equivocal response (primary cough headache, PCH). Patients 4, 13 and 16 had ‘cough headache’ but did not complain of headache with coughing.