Cerebral Concussion as a Cause of Cough Syncope

Studies of circulatory changes during cough syncope by Sharpey-Schafer¹and by McIntosh et al.²imply that the mechanism of this syndrome has been satisfactorily explained. Their explanations seem unsuitable in instances of certain patients studied recently. Our results indicate that the termcough concussionmay be preferable tocough syncopein certain instances.

Methods

Eighteen patients presenting the typical features of cough syncope³have been observed. Voluntary coughing could produce syncope at will in 5 patients, and 21 episodes were studied in these. In addition to the usual clinical observations made on patients with syncope, electroencephalograms^*have been recorded in 11 patients; intra-arterial pressures have been recorded in 10 instances, and an antigravity suit has been used with one subject. Peripheral arterial pressures were recorded from an indwelling Cournand needle in the brachial artery. Central aortic pressures were recorded through a polyvinyl catheter 24 cm. long with