A cluster headache is an uncommon type of headache. It is one-sided head pain that may involve tearing of the eyes, a droopy eyelid, and a stuffy nose. Attacks last from 15 minutes to 3 hours, occur daily or almost daily for weeks or months. The attacks are separated by pain-free periods that last at least 1 month or longer.
Cluster headaches may be confused with other common types of headaches such as migraines, sinus headache, and tension headache.
Histamine headache; Headache - histamine; Migrainous neuralgia; Headache - cluster; Horton's headache; Vascular headache - cluster; Episodic cluster headache; Chronic cluster headache
Doctors do not know exactly what causes cluster headaches. They seem to be related to the body's sudden release of histamine (chemical in the body released during an allergic response) or serotonin (chemical made by nerve cells) in the area of a nerve in the face called the trigeminal nerve. A problem in a small area at the base of the brain called the hypothalamus may be involved.
More men than women are affected. The headaches can occur at any age, but are most common in the 20s through middle age. They tend to run in families.
Cluster headaches may be triggered by:
A cluster headache begins as a severe, sudden headache. The headache commonly strikes 2 to 3 hours after you fall asleep. But it can also occur when you are awake. The headache tends to happen daily at the same time of day. Attacks can last for months. They can alternate with periods without headaches (episodic) or they can go on for a year or more without stopping (chronic).
Cluster headache pain is usually:
When the eye and nose on the same side as the head pain are affected, symptoms can include:
Treatment for cluster headaches involves:
TREATING CLUSTER HEADACHES WHEN THEY OCCUR
Your provider may recommend the following treatments for when the headaches occur:
You may need more than one of these treatments to control your headache. Your provider may have you try several medicines before deciding which works best for you.
Pain medicines and narcotics do not usually relieve cluster headache pain because they take too long to work.
Surgical treatment may be recommended for you when all other treatments have failed. One such treatment is a neurostimulator. This device delivers tiny electrical signals to certain nerves such as the occipital nerve in the scalp. Your provider can tell you more about surgery.
PREVENTING CLUSTER HEADACHES
Avoid smoking, alcohol use, certain foods, and other things that trigger your headaches. A headache diary can help you identify your headache triggers. When you get a headache, write down the following:
Review your diary with your provider to identify triggers or a pattern to your headaches. This can help you and your provider create a treatment plan. Knowing your triggers can help you avoid them.
The headaches may go away on their own or you may need treatment to prevent them. The following medicines may also be used to treat or prevent headache symptoms:
Manjit Matharu is in London, United Kingdom. Matharu is rated as an Elite expert by MediFind in the treatment of Cluster Headache. She is also highly rated in 7 other conditions, according to our data. Her top areas of expertise are Cluster Headache, Headache, Migraine, and New Daily Persistent Headache.
Peter Goadsby is a Neurologist in Los Agneles, California. Dr. Goadsby has been practicing medicine for over 37 years and is rated as an Elite doctor by MediFind in the treatment of Cluster Headache. He is also highly rated in 12 other conditions, according to our data. His top areas of expertise are Migraine, Familial Hemiplegic Migraine, Migraine with Brainstem Aura, and Headache. He is licensed to treat patients in California.
Charly Gaul is in Frankfurt Am Main, Germany. Gaul is rated as an Elite expert by MediFind in the treatment of Cluster Headache. They are also highly rated in 5 other conditions, according to our data. Their top areas of expertise are Cluster Headache, Migraine, Headache, and Trigeminal Neuralgia.
Cluster headaches are not life threatening. They usually do not cause permanent changes to the brain. But they are long-term (chronic), and often painful enough to interfere with work and life. However, they can occur less frequently with age.
Call 911 if:
Schedule an appointment or contact your provider if:
If you smoke, now is a good time to stop. Alcohol use and any foods that trigger a cluster headache may need to be avoided. Medicines may prevent cluster headaches in some cases.
Published Date : November 09, 2021
Published By : Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Hoffmann J, May A. Diagnosis, pathophysiology, and management of cluster headache. Lancet Neurol. 2018;17(1):75-83. PMID: 29174963 www.ncbi.nlm.nih.gov/pubmed/29174963/.
Rozental JM. Tension-type headache, chronic tension-type headache, and other chronic headache types. In: Benzon HT, Raja SN, Liu SS, Fishman SM, Cohen SP, eds. Essentials of Pain Medicine. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 20.