Cluster Headaches

Overview, Causes, & Risk Factors

Cluster headaches are headaches that are spaced close together. They often occur 1 to 2 times a day for several weeks. This cycle of headaches may suddenly stop altogether but can reappear weeks or even years later.

What is going on in the body?

The cause of cluster headaches is unknown. Experts believe that they begin in the part of the brain that manages daily changes in the function of body organs.

What are the causes and risks of the condition?

The causes and risks of cluster headaches are unknown. Cluster headaches occur most often in men between the ages of 20 and 40. Smoking and alcohol use can trigger a cluster headache. Some cluster headaches may be triggered by nasal congestion.

Symptoms & Signs

What are the signs and symptoms of the condition?

Cluster headaches usually last less than 1 hour and rarely longer than 4 hours. The pain is usually sudden and severe. It may feel like a stabbing sensation on one side of the head. An individual may feel pain in one eye. The eye may swell and turn red.

Someone with a cluster headache usually moves around trying to find a position to ease the pain. Some people even rock back and forth seeking relief or distraction.

Following are some of the other symptoms of cluster headaches:

  • flushing of the face
  • pain that spreads to the face and neck
  • runny nose or nasal congestion
  • tearing from the eyes
  • Diagnosis & Tests

    How is the condition diagnosed?

    Diagnosis of a cluster headache begins with a medical history and physical exam. The healthcare provider may order tests to rule out other causes of the headaches. These tests may include a cranial CT scan or cranial MRI.

    Prevention & Expectations

    What can be done to prevent the condition?

    In general, cluster headaches cannot be prevented. Someone who smokes should quit smoking. It may also be helpful to limit alcohol intake. Treatment of nasal congestion may eliminate some headache triggers.

    What are the long-term effects of the condition?

    Cluster headaches have no significant long-term effects.

    What are the risks to others?

    Cluster headaches are not contagious and pose no risk to others.

    Treatment & Monitoring

    What are the treatments for the condition?

    Some cluster headaches improve when the person inhales oxygen for a short period of time. The healthcare provider may also prescribe two types of medications. Preventive medications are used to prevent cluster headaches. Other medications are used to treat a cluster headache once it develops.

    Preventive medications include the following:

  • calcium channel blockers, such as verapamil
  • corticosteroids, such as prednisone
  • lithium
  • methysergide
  • Following are some of the medications that can be used during a cluster headache:

  • dihydroergotamine, which is inhaled as a spray up the nose
  • ergotamine, which may be inhaled, injected, or inserted rectally
  • a local anesthetic, which is inhaled up the nose
  • sumatriptan, which is injected under the skin
  • What are the side effects of the treatments?

    Many of the medications used to treat cluster headaches cause an increase in blood pressure. Corticosteroids may cause increased risk of infection, osteoporosis, and bleeding. Lithium may cause increased thirst and urination. It may also cause nausea and trembling of the hands. Calcium channel blockers may significantly increase a person’s risk for stroke and heart attack. Methysergide can cause a hardening of the lung tissue.

    What happens after treatment for the condition?

    Preventive medications usually do a good job of reducing the number of cluster headaches. Medications given during the headache can reduce the pain and shorten the length of the headache.

    How is the condition monitored?

    Any new or worsening symptoms should be reported to the healthcare provider.

    Article type: xmedgeneral