What should you know about cough and persistent headache?

Respiratory infection, sinus inflammation, dehydration, medicine effects and straining during a cough are among the possibilities. Brain tumours, including glioblastoma or brain metastases, can present with persistent or changing headaches, but symptoms alone cannot identify their cause.

A headache felt mainly during forceful coughing may result from a temporary rise in pressure caused by straining. A headache that continues between coughing episodes, becomes progressively more troublesome, wakes you from sleep or differs from your usual headaches deserves clinical review.

For the cough, useful details include whether it is dry or produces mucus, how long it has lasted, and whether there is fever, breathlessness, chest pain, wheezing, hoarseness or blood. For the headache, note its location, onset, triggers and any nausea, visual change, weakness, confusion or balance difficulty.

Book a medical appointment if the headache persists, the cough is not settling, or either symptom is worsening. Record when each symptom began and whether one triggers the other. Bring a list of medicines, including inhalers and pain relievers, along with details of recent infections, smoking or vaping exposure and any history of cancer.

A clinician may examine the chest and nervous system, measure vital signs and decide whether chest imaging, brain imaging or other tests are appropriate. Avoid repeatedly increasing pain medicine without advice because frequent use can itself sustain some headaches.

Seek emergency care for a sudden extremely severe headache, new weakness or numbness, difficulty speaking, a seizure, fainting, severe confusion or loss of vision. Coughing with severe breathlessness, blue or grey lips, crushing chest pain or more than a small streak of blood also calls for emergency assessment.

Get same-day medical advice for a worsening headache with repeated vomiting, fever with neck stiffness, new clumsiness or a notable change in alertness. Urgency comes from these warning features, not from guessing which diagnosis is most common.

Ask whether the cough and headache appear connected, what the examination suggests, which warning signs to watch for and when imaging would add useful information. If you have cancer, ask whether your diagnosis or treatment changes the investigation plan.