Cluster Headaches

Cluster headaches are rare when compared with other types of headaches. The pain they produce is severe and tends to recur in the same way each time. They occur in groups, or clusters. . Each attack lasts about 15 minutes to 3 hours on average. They may occur every other day, up to multiple times a day. Cluster periods are followed by remissions where there are no headaches. These cluster may last months or years.

Men are affected by cluster headaches more than women. They typically start around age 30 and more than 90% of those with cluster have smoked in the past. 

Researchers don't know exactly what causes cluster headaches. They seem to start in a part of the brain called the hypothalamus, which controls biorhythms, sleep and hormones.    

The following may trigger cluster headaches:

• Alcohol use.
• Change to a high altitude.

These are common symptoms of a cluster headache:

• Sudden onset of pain, that is severe in intensity.
• One side headache generally around or behind the eye
• Pain builds to a peak in about 10 to 15 minutes.
• Symptoms on the same side as the headache:
  • Red or watering eye.
  • Nasal congestion.
  • Sweating on the forehead.
  • Eyelid drooping or swelling.

The symptoms of a cluster headache may look like other health conditions. Always see your doctor for a diagnosis.

Your healthcare provider will diagnose cluster headaches based on the severity and location of the headaches, their short duration and symptoms like tearing of the eyes and a runny nose on the side of the headache. 

A two-pronged approach is used for treatment of cluster headaches:

• Stopping an attack.
• Preventing future attacks.

To stop or at least control an attack in progress, you may be given high-dose oxygen therapy through a face mask for 15 to 20 minutes. Your healthcare provider may also prescribe a nasal spray or shot of sumatriptan to ease the severe pain of a cluster headache. This medicine causes blood vessels in the brain to constrict and deactivates the trigeminal nerve, which is the main nerve in the head involved with cluster headache.  There also is a vagal nerve stimulator that is a hand held device that can be used to stop the pain of a cluster attack.

The second part of cluster headache treatment is to prevent recurrent attacks by using daily medicine. Several medicines are used to prevent cluster headache attacks:

• Verapamil. A medicine that relaxes blood vessels.
• Prednisone. A steroid that reduces inflammation and swelling.
• Anti-seizure medicines. Medicines that may help reduce the number of cluster headaches.

A true cluster headache is not life threatening. It does not cause permanent brain damage. But, they tend to be long-term (chronic) and recurrent. They can interfere with your lifestyle or work.

To prevent a cluster headache, it’s important to find out what triggers your headaches. Try not smoking and using alcohol. Your healthcare provider may be able to prescribe a medicine plan that will help prevent cluster headaches.

Some danger signs may occur with cluster headaches that mean you should get medical care right away. These include:

• Loss of movement or sensation.
• Drowsiness.
• Seizure activity.
• Changes in vision.