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Be vigilant in a search for secondary causes. Unfortunately, SUNHA does not respond to indomethacin as do PH and HC.  11, but is usually lamotrigine or gabapentin. Pathophysiology of the TACs: What you Need to Know There is now a substantial body of evidence that the spectrum of TACs and the Other Primary Headaches are related in their pathophysiological origin, as one would suspect, since they generally share many clinical features. Recent advances with positron emission tomography (PET) scanning and functional MRI have demonstrated areas of activation in the posterior hypothalamus for all of the TACs during the headache phase.

Org S. J. Tepper, D. E. 1007/978-3-319-04072-1_3, © Springer International Publishing Switzerland 2014 35 36 M. J. 2 Diagnostic criteria for primary cough headache, ICHD-3 A. At least two headaches with: B. Sudden onset, lasting from 1 s to 120 min C. Brought on by and occurring only with cough, sneeze, strain, and/or valsalva D. Secondary causes excluded Primary Cough Headache Clinically, cough headache is a paroxysm, a quick upstroke of pain in less than a second, with a gradual resolution of generally less than 5 min.

Occasionally, the headaches can be unilateral. Unlike the TACs, it is not associated with parasympathetic discharge or other autonomic features. Workup for HH includes an MRI without and with contrast. Tumor and CSF leak have both been reported to cause secondary HH. As always, a sedimentation rate should be obtained if this is the new onset of headache in an elderly patient, because of the variable presentations of giant cell arteritis. HH tends to be a geriatric headache disorder, mostly in people over the age of 50.

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