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Cluster Headache

Abstract

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NORD is very grateful to Olivia Lanes, NORD Intern and Frederick R. Taylor, MD, Park Nicollet Headache Center, Adjunct Professor of Neurology, University of Minnesota, for assistance in the preparation of this report.

Synonyms of Cluster Headache

  • familial cluster headaches
  • histamine cephalalgia
  • vasogenic facial pain

Disorder Subdivisions

  • chronic cluster headache
  • episodic cluster headache

General Discussion

Summary
Cluster headaches (CH) are an uncommon, severe form of primary neurovascular headaches. CH are the most painful form of headaches, with the pain occurring on one side of the head and behind or above the eye or at the temple most commonly. The pain has been described as searing, burning and stabbing. The age of onset of CH is most often between 20 and 40, and they are more common in men than women with a ratio of 2:1. CH attacks also include one or more cranial autonomic symptoms (CAS) on the same side of the head as the pain (ipsilaterally) such as red eye (conjunctival injection), eyelid swelling (edema), forehead and facial sweating, tearing (lacrimation), abnormally small size of the pupil (miosis), nasal congestion, runny nose (rhinorrhea), and drooping eyelid (ptosis). CH is divided into episodic and chronic. Episodic cluster headache patients usually suffer from 1 to 4 short headaches a day that can individually last between 15-120 minutes when they are having a series of attacks. These attacks (cluster periods) last for weeks or months and are separated by months or years of remission periods where the patients are pain-free. Chronic cluster headache patients suffer without remissions for 1 year or more or with remissions so brief they do not even span a month. Less than 20% of cluster headache patients have the chronic form. It is not yet clear what causes CH, but scientists have discovered a lot of recent evidence that links it to the part of the brain called the hypothalamus. There is no cure, and treatment is determined on an individual basis. However, the two most effective types of acute or symptomatic treatment, high-flow inhaled oxygen and injections of subcutaneous sumatriptan, have been proven to be effective in reducing the pain from CH.

Introduction
Cluster headaches were first completely described by the London neurologist Wilfred Harris in 1926. At that time, it was believed that nearly 90% of CH patients were men, while women instead suffered with migraine headaches. Although it has been confirmed that men are more at risk for developing CH, that ratio has decreased significantly. Researchers theorize that this is because women have long been misdiagnosed with migraines instead. Treatment for migraine headaches differ in several ways from CH, so an accurate diagnosis is important.

Organizations related to Cluster Headache

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