This type of headache typically requires a brain MRI with contrast (preferably) and a non-contrast brain MRA to also look at the arteries of the brain. Alternatively would be a CTA brain if MRI can not be done. Most often it is a benign headache disorder. Chiari malformation is a common anatomical variation often associated with cough headache, or headache brought on by exertion, bearing down (such as having a bowel movement), laughing hard, etc.
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Virtual Headache Specialist™ is NEVER a replacement for an office visit with a medical doctor. Diagnoses and treatment suggestions of any type cannot be made without a face-to-face office visit with a medical doctor, and a detailed medical history and examination first.