Cluster Headache

Cluster Headache is a primary headache disorder characterized by severe pain that occurs in a group or pattern, known as a cluster period. This type of headache is relatively rare compared to other types of headaches, affecting about .1% of the population. 

Cluster Headache is a primary headache disorder characterized by severe pain that occurs in a group or pattern, known as a cluster period. This type of headache is relatively rare compared to other types of headaches, affecting about .1% of the population

What Causes It?

Researchers do not yet know the exact cause of cluster headaches. They affect all genders equally, most commonly beginning in a person’s 30s or 40s. There is evidence of a genetic risk factor — a person is more likely to experience them if one or both of their parents do.

Pain is caused by the dilation of blood vessels in the hypothalamus, the part of the brain linked to the nervous system and to nerves in the face. People experiencing cluster headaches often report severe pain focused around the eye. 

Triggers may cause the onset of a cluster period or may worsen a headache during the cluster period. Common triggers include:

  • Cigarette smoking or alcohol
  • An inconsistent sleep cycle, disturbed circadian rhythm, or sleep disorders such as sleep apnea
  • Sudden changes in blood pressure
  • Altitude changes
  • Bright light
  • Sudden rises in temperature or exercising in hot weather
  • Allergies and nasal congestion

What Are the Symptoms?

A cluster headache is sudden, severe intense pain that can last from 30 minutes to 3 hours, with pain generally peaking 10-15 minutes into the attack. It is described as burning, sharp, stabbing, or steady; often felt on one side of the face from the neck to the temple, sometimes focused around the eye. Other symptoms can include restlessness or agitation, red or watering eyes, and stuffiness or runny nose on the affected side of the face.

A person with episodic cluster headaches may experience a cluster period from one week to a year, followed by a period of pain-free remission lasting up to 12 months. By contrast, a person with chronic cluster headaches can experience even longer cluster periods and shorter periods of remission. 

How Is It Diagnosed?

To diagnose cluster headaches, specialists look primarily for these patterned cluster periods of severe head pain. If pain is inconsistent or accompanied by other symptoms such as nausea, vertigo, or visual symptoms, it is likely another type of migraine. 

How Is It Treated?

When pain is in progress, a healthcare professional might recommend oxygen therapy — breathing 100% pure oxygen through a face mask — or use of a sumatriptan nasal spray, which can help dilate blood vessels in the brain and subdue the pain. Other remedies can include injection of dihydroergotamine (DHE) (not used in conjunction with sumatriptan) or application of capsaicin cream to the area of pain.

Is It Preventable?

The best way to prevent cluster periods is to avoid known triggers — for example, if drinking alcohol during a cluster period worsens head pain, it makes sense to avoid it. A headache specialist can prescribe daily preventative medication to help avert inflammation of blood vessels. 

Cluster Headache is a primary headache disorder characterized by severe pain that occurs in a group or pattern, known as a cluster period. This type of headache is relatively rare compared to other types of headaches, affecting about .1% of the population

What Causes It?

Researchers do not yet know the exact cause of cluster headaches. They affect all genders equally, most commonly beginning in a person’s 30s or 40s. There is evidence of a genetic risk factor — a person is more likely to experience them if one or both of their parents do.

Pain is caused by the dilation of blood vessels in the hypothalamus, the part of the brain linked to the nervous system and to nerves in the face. People experiencing cluster headaches often report severe pain focused around the eye. 

Triggers may cause the onset of a cluster period or may worsen a headache during the cluster period. Common triggers include:

  • Cigarette smoking or alcohol
  • An inconsistent sleep cycle, disturbed circadian rhythm, or sleep disorders such as sleep apnea
  • Sudden changes in blood pressure
  • Altitude changes
  • Bright light
  • Sudden rises in temperature or exercising in hot weather
  • Allergies and nasal congestion

What Are the Symptoms?

A cluster headache is sudden, severe intense pain that can last from 30 minutes to 3 hours, with pain generally peaking 10-15 minutes into the attack. It is described as burning, sharp, stabbing, or steady; often felt on one side of the face from the neck to the temple, sometimes focused around the eye. Other symptoms can include restlessness or agitation, red or watering eyes, and stuffiness or runny nose on the affected side of the face.

A person with episodic cluster headaches may experience a cluster period from one week to a year, followed by a period of pain-free remission lasting up to 12 months. By contrast, a person with chronic cluster headaches can experience even longer cluster periods and shorter periods of remission. 

How Is It Diagnosed?

To diagnose cluster headaches, specialists look primarily for these patterned cluster periods of severe head pain. If pain is inconsistent or accompanied by other symptoms such as nausea, vertigo, or visual symptoms, it is likely another type of migraine. 

How Is It Treated?

When pain is in progress, a healthcare professional might recommend oxygen therapy — breathing 100% pure oxygen through a face mask — or use of a sumatriptan nasal spray, which can help dilate blood vessels in the brain and subdue the pain. Other remedies can include injection of dihydroergotamine (DHE) (not used in conjunction with sumatriptan) or application of capsaicin cream to the area of pain.

Is It Preventable?

The best way to prevent cluster periods is to avoid known triggers — for example, if drinking alcohol during a cluster period worsens head pain, it makes sense to avoid it. A headache specialist can prescribe daily preventative medication to help avert inflammation of blood vessels. 

Sources

Sources

  1. NIH/National Library of Medicine. Cluster Headache: Epidemiology, Pathophysiology, Clinical Features, and Diagnosis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5909131/
  2. National Organization for Rare Disorders, Inc. (NORD). Cluster Headache. https://rarediseases.org/rare-diseases/cluster-headache/
  3. Johns Hopkins Medicine. Cluster Headaches. https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/cluster-headaches
  4. WebMD. Cluster Headaches. https://www.webmd.com/migraines-headaches/cluster-headaches
  5. ClevelandClinic. Cluster Headaches. https://my.clevelandclinic.org/health/diseases/5003-cluster-headaches
  6. Healthline. Cluster Headaches. https://www.healthline.com/health/cluster-headache

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