CLINACASE

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ID: 130
Category: General
CreatedBy: 1
UpdatedBy: 1
createdon: 14 Jul 2017
updatedon: 04 Apr 2023

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Author: Khoa Tran
Published Jul 14, 2017
Updated Apr 04, 2023

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Cluster Headache

History of Cluster Headache

The history of cluster headache can be traced back to the early 1800s, when it was first described by the English physician Thomas Willis.

Over the years, medical researchers have studied cluster headache in greater detail, leading to a greater understanding of its causes and potential treatments. In the 1930s, the first effective treatment for cluster headache was discovered, with the use of a medication called ergotamine.

In the 1950s and 1960s, researchers began to identify specific triggers for cluster headache, such as alcohol and certain foods, and developed new treatments to manage symptoms. In the 1970s, the use of oxygen therapy was introduced as a potential treatment for cluster headache, which remains a widely used and effective treatment today.

Modern Understanding of Cluster Headache

Cluster headache is a rare but extremely painful headache disorder that affects people in a recurring pattern or "cluster". It is also known as the "suicide headache" due to its intense nature. There are two main types of cluster headache: chronic and episodic. Chronic cluster headache is when headaches occur for more than one year without any significant break, while episodic cluster headache is when headaches occur in clusters for several weeks to months followed by headache-free periods lasting for several months to years.

Cluster headache is a type of headache disorder known as trigeminal autonomic cephalalgias, characterized by severe headache that is unilateral, meaning it affects only one side of the head. The pain is felt around the eye or orbital area, often described as periorbital or ocular pain, and is accompanied by autonomic symptoms such as nostril pain, facial sweating, conjunctival injection, lacrimation, rhinorrhea, miosis, ptosis, eyelid swelling, preauricular pain, and temporal pain.

Cluster headaches vs migraines

Cluster headaches and migraines are two different types of headaches, although they have some similarities. Migraines are a type of headache that can cause intense, throbbing pain, often on one side of the head, as well as other symptoms such as nausea, vomiting, and sensitivity to light and sound. Migraines can last for several hours to a few days. Cluster headaches, on the other hand, are characterized by severe, recurring pain, often on one side of the head, typically around the eye or temple area. They tend to occur in clusters or groups, with multiple headaches occurring daily or nearly daily over a period of several weeks, followed by a headache-free period. The main difference between the two is the pattern and frequency of headaches. Migraines are less frequent and last longer, while cluster headaches occur more frequently and are shorter in duration. Additionally, cluster headaches are often more intense and cause more noticeable symptoms, such as red and watery eyes, nasal congestion or runny nose, and a drooping eyelid.

Causes of Cluster Headache

The exact cause of cluster headache is unknown, but some possible triggers include alcohol consumption, high altitude, and certain foods. Treatments for cluster headache can include medications such as indomethacin, verapamil, lithium carbonate, melatonin, topiramate, corticosteroids, and triptans such as sumatriptan, zolmitriptan, and rizatriptan. In some cases, oxygen therapy, nitroglycerin, intranasal lidocaine, sphenopalatine ganglion block, percutaneous occipital nerve stimulation, stellate ganglion block, and occipital nerve stimulation may also be used.

Treatments for Cluster Headache

- Medications: Several medications can be used to treat cluster headaches, including triptans, which help to reduce inflammation and constrict blood vessels, and corticosteroids, which help to reduce inflammation and pain. Other medications, such as lithium and verapamil, may also be used to manage symptoms and prevent attacks.
- Oxygen therapy: Oxygen therapy is a non-invasive treatment option that involves breathing in pure oxygen through a mask. This can help to reduce inflammation and pain and may be particularly effective for individuals who experience attacks during the night.
- Nerve blocks: Nerve blocks involve injecting an anesthetic into the nerves that are responsible for the pain associated with cluster headaches. This can provide immediate relief and may be useful for individuals who do not respond well to other treatments.
- Lifestyle changes: Certain lifestyle changes may help to reduce the frequency and severity of cluster headaches. This may include avoiding triggers such as alcohol and certain foods, practicing stress-reducing techniques such as meditation and yoga, and getting regular exercise.

It is important to note that the effectiveness of these treatments can vary from person to person, and a healthcare provider will work with individuals to determine the best course of treatment based on their specific needs and symptoms.

Symptoms

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Headache
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Severe headache that doesn't go away

Confirmation Tests

- CT scan
- MRI

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