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Cluster Headache

Cluster headaches are characterized by excruciating, piercing pain on one side of the head and eye; they occur more frequently in men than women.

PubMed Health Glossary
(Source: NIH - National Institute of Neurological Disorders and Stroke)

About Cluster Headaches

Cluster headache - the most severe form of primary headache - involves sudden, extremely painful headaches that occur in "clusters," usually at the same time of the day and night for several weeks. They strike one side of the head, often behind or around one eye, and may be preceded by a migraine-like aura and nausea. The pain usually peaks 5 to 10 minutes after onset and continues at that intensity for up to 3 hours. The nose and the eye on the affected side of the face may get red, swollen, and teary. Some people will experience restlessness and agitation, changes in heart rate and blood pressure, and sensitivity to light, sound, or smell. Cluster headaches often wake people from sleep.

Cluster headaches generally begin between the ages of 20 and 50 but may start at any age, occur more often in men than in women, and are more common in smokers than in nonsmokers. The attacks are usually less frequent and shorter than migraines. It's common to have 1 to 3 cluster headaches a day with 2 cluster periods a year, separated by months of freedom from symptoms. The cluster periods often appear seasonally, usually in the spring and fall, and may be mistaken for allergies. A small group of people develop a chronic form of the disorder, which is characterized by bouts of headaches that can go on for years with only brief periods (1 month or less) of remission....Read more about Cluster Headaches NIH - National Institute of Neurological Disorders and Stroke

What works? Research summarized

Evidence reviews

Triptans for acute cluster headache

Cluster headaches are excruciating headaches of extreme intensity. They can last for several hours, are usually on one side of the head only, and affect men more than women. Multiple headaches can occur over several days. Fast pain relief is important because of the intense nature of the pain with cluster headache.

Acute and preventive pharmacologic treatment of cluster headache

The authors recommend offering subcutaneous sumatriptan 6mg, intranasal zolmitriptan 5mg and 10mg and 100% oxygen for treatment of cluster headaches. Preventive therapies that should or may be considered were recommended in the review. Given the potential for missed data and the limited evidence for the different treatments, the authors’ recommendations should be interpreted with caution.

Normal pressure oxygen therapy and hyperbaric oxygen therapy for migraine and cluster headaches

Migraine and cluster headaches are severe and disabling. Both hyperbaric oxygen therapy (HBOT) and normal pressure oxygen therapy (NBOT) have been suggested as effective treatments to end acute attacks and prevent future attacks. HBOT involves people breathing pure oxygen in a specially designed chamber. In our review, we found some weak evidence to suggest that HBOT helps people with acute migraine headaches and possibly cluster headaches, and that NBOT may help people with cluster headache. We found no evidence that either can prevent future attacks. Because many migraines can be treated simply with appropriate drug therapy, further research is needed to help choose the most appropriate patients (if any) to receive HBOT.

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Summaries for consumers

Triptans for acute cluster headache

Cluster headaches are excruciating headaches of extreme intensity. They can last for several hours, are usually on one side of the head only, and affect men more than women. Multiple headaches can occur over several days. Fast pain relief is important because of the intense nature of the pain with cluster headache.

Signs of migraine and other types of headaches

There are several different types of headaches referred to as "primary" headaches. Primary headaches are headaches that happen on their own: They are not caused by something else, such as an illness or hitting your head.These are the major types of primary headache:Tension-type headache:The pain feels like pressing or tightening and is on both sides of the head.The pain is light to moderate.The headaches last anywhere from 30 minutes to several days.They do not usually happen more than once a month.The headache does not cause nausea, but might cause sensitivity to light.Physical activity does not make the headache worse.This is the most common type of headache. People who have migraines might get these as well.Cluster headache:Searing or piercing pain around the eye on one side of the head. The headaches are usually on the same side of the head.The pain is severe.The headaches last from 15 minutes to 3 hours.They happen very often: every other day, and usually several times a day.Besides pain inside the head, it may cause a stuffy nose, watery eyes and other nose and eye symptoms.Cluster headaches are not common, and men are more likely than women to have them.Migraine:A migraine attack is associated with an intense pulsing, pounding or throbbing pain, concentrated at the front of the head and usually on one side – but not always the same side.The pain is moderate to severe.In teenagers and adults, the headaches last for at least four hours and up to three days. In children they last at least two hours and may go away more quickly.The headache needs to have occurred more than five times to be considered a migraine. Migraines are sometimes more common during menstruation (a woman's period).Besides pain, a migraine usually causes sensitivity to light and/or sound. Migraines are often associated with nausea.There may or not be symptoms called "auras": These are flashing lights or other visual abnormalities, and they could happen before or during the migraine. Not all migraines have auras.Physical activity usually makes the headache worse.They are not as common as tension headaches, but they affect many children and adults. Migraines are more likely to affect women.A person who has a migraine often needs to lie down somewhere dark and quiet and lie down to get away from light, sounds and movement. This is one of the main differences between migraines and other types of headaches.Children with migraines will usually avoid bright light, and they might be pale, feel nauseous and have to vomit. They may also have abdominal (lower belly) pain that lasts between 1 hour and 3 days. This is often called "abdominal migraine," although not all doctors and researchers agree that there is a separate type of migraine in children that mostly causes abdominal pain instead of headache in children.

Normal pressure oxygen therapy and hyperbaric oxygen therapy for migraine and cluster headaches

Migraine and cluster headaches are severe and disabling. Both hyperbaric oxygen therapy (HBOT) and normal pressure oxygen therapy (NBOT) have been suggested as effective treatments to end acute attacks and prevent future attacks. HBOT involves people breathing pure oxygen in a specially designed chamber. In our review, we found some weak evidence to suggest that HBOT helps people with acute migraine headaches and possibly cluster headaches, and that NBOT may help people with cluster headache. We found no evidence that either can prevent future attacks. Because many migraines can be treated simply with appropriate drug therapy, further research is needed to help choose the most appropriate patients (if any) to receive HBOT.

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Terms to know

Aura
An aura is a perceptual disturbance experienced by some with migraine or seizures before either the headache or seizure begins.
Headache
Head pain or discomfort.
Nausea
A feeling of sickness or discomfort in the stomach that may come with an urge to vomit.
Primary Headaches
Headaches that occur on their own with no detectable underlying cause, such as migraine.

More about Cluster Headache

Photo of an adult man

Also called: Cluster headache syndrome, Histamine cephalgia, Histamine headache, Horton's headache, Horton's neuralgia, Migrainous neuralgia, Neuralgic migraine, Vasomotor headache

See Also: Migraine, Tension-Type Headache

Other terms to know: See all 4
Aura, Headache, Nausea

Related articles:
Migraine: Overview
Signs of Migraine and Other Types of Headaches

Keep up with systematic reviews on Cluster Headache:

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