A cluster headache is one-sided head pain that may involve tearing of the eyes and a stuffy nose. Attacks occur regularly for 1 week to 1 year, separated by long pain-free periods that last at least 1 month, possibly longer.
Causes, incidence, and risk factors Cluster headaches are a fairly common form of chronic, repeated headaches. They are four times more common in men than women. The headaches can occur at any age but are most common in adolescence and middle age. They tend to run in families, passed down through genes.
Scientists do not know exactly what causes cluster headaches, but they appear to be related to the body's sudden release of histamine or serotonin. A problem in a small area at the base of the brain called the hypothalamus may be involved.
The following may trigger cluster attacks: Alcohol, cigarette smoking, high altitudes, bright lights, heat.
A cluster headache begins as a severe, sudden headache. The headache most commonly strikes 2 to 3 hours after you fall asleep. However, the headache may occur while you are awake. The headache tends to occur at the same time of day.
The pain occurs on one side of the head. It may be described as: Burning, sharp and steady chronic pain.
The pain may occur in, behind, and around one eye. It may: Involve one side of the face from neck to temples.
- The strongest chronic pain may last 30 minutes to 2 hours.
- Cluster headaches may occur daily for months, alternating with periods without headaches (episodic), or they can recur for a year or more without stopping (chronic).
Signs and tests your health care provider can diagnose this type of headache by performing a physical exam and asking questions about your symptoms and medical history.
Tests, such as an MRI of the head, may be needed to rule out other causes of the headaches.
Your doctor may recommend the following treatments for when the headaches occurs:
- Triptans, such as sumatriptan (Imitrex)
- Two to 3 weeks of anti-inflammatory (steroid) medicines such as prednisone -- starting with a high dose, then slowly decreasing it
- Breathing in 100% (pure) oxygen
- You may need more than one of these treatments to control headache symptoms. Your doctor may have you try several medications before deciding which works best for you.
Painkillers and narcotics do not usually relieve the chronic pain from cluster headaches. Generally, they take too long to work.
A headache diary can help you identify your headache triggers. When you get a headache, write down the day and time the pain began. The diary should include notes about:
- What you ate and drank in the last 24 hours, how much you slept and when, and what was going on in your life right before the pain started. For example, were you under any unusual stress?
- About how long the headache lasted, and what made it stop.
- Cluster headaches do not respond to treatment
- Headaches disturb your sleep
- You get headaches whenever you are active
- Headaches occur with other symptoms
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