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strong cough
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strong cough

I have had a strong cough for about 3 weeks, however for the last week the cough has caused severe pain on the rear of my head as if my brain were banging into my skull.  Also when I cough I see 4 very bright flashes of light as if they were coming from each temple and each cheek bone.
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Your description suggests that this is a very harsh cough, one that could cause a muscle tension headache at the rear of your skull.  Rarely, such strong coughing can cause more serious injury to intracranial blood vessels and/or adjacent structures.  Concern about these more serious complications would be warranted if the headache was severe and unremitting; that is a continuous headache and not just one that occurs during a cough.

Cough headache is an uncommon, but important complication of cough.  The most accepted explanation is that the cough is caused by a rapid increase in intracranial pressure.  However, rarely, cough can provoke headaches due to:  1) cerebral aneurysm, which is a weakness of a blood vessel wall associated with a bulge; 2) stenosis of the carotid artery; 3) basilar artery disease; 4) space occupying lesions; and 5) subdural hematoma.

It would be prudent for you to see your doctor for evaluation of this headache to include a determination by him/her of whether further investigation is warranted such as consultation with a neurologist, evaluation of your carotid artery blood flow, a CT scan of the brain or a magnetic resonance imaging (MRI) of the brain.  The odds of your headache being benign are very much in your favor but a face to face evaluation by your doctor would enable him/her to put your headaches in the proper perspective.

Good luck.
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