Hello! Thank you for asking on HCM! I understand your concern. Your symptoms seem to be related to a primary cough headache ( where other intracranial causes have been excluded with imaging studies , like in your case). Most of the primary cough headache patients remit spontaneously after maximum 4 years, however, patients with a disease duration of 12 years and more have been described in different studies. I would recommend to perform an ophtalmological evaluation for papilledema, to exclude a possible intracranial hypertension, which could mimic this clinical scenario. I would advise you to start therapy with Indomethacine twice daily for some months (up to six months). Other treatment options would be topiramate and beta-blockers. Hope to have been helpful! Greetings! Dr. Aida