What Is a Cluster Headache?
Cluster
headaches, a type of vascular headache, are known for their extreme pain and their pattern of occurring in "clusters," usually at the same time(s) of the day for several weeks. Cluster headaches have been called the "suicide headache," "demon of headaches," and, because it often wakens the person, "alarm clock headache."
Who Gets Cluster Headaches?
Nearly a million Americans have cluster headaches. Most cluster patients are men, usually smokers. Cluster headaches usually start between the ages of 20 and 40, although the syndrome can also start in childhood or late in life.
Types of Cluster Headaches
There are two type of cluster headache -- episodic cluster headaches and chronic cluster headaches.
Episodic cluster headaches are the most common type, occurring in up to 90 percent of people who have this condition. Episodic cluster headaches occur up to eight times per day for four to eight weeks, on average. This is followed by a six-month to one-year pain-free period, although this pain-free period can last for years.
Chronic cluster headaches, on the other hand, can go on for years with only brief periods (two weeks or less) of remission.
Either type of cluster headache can turn into the other for unknown reasons.
Headache research scientists do not know the specific cause or causes of cluster headaches. Cluster headaches have not been linked to hormones or foods (as
migraines have).
There are, however, certain factors that can increase a person's risk for developing this type of headache. Specific cluster headache risk factors include:
- Family history of cluster headaches (up to a 14-fold increased risk)
- Hazel eyes
- Disruption of normal sleep patterns
- Certain medications (such as nitroglycerin)
- Heavy smoking or drinking.
Symptoms of Cluster Headaches
Cluster headaches may begin as a minor pain or pressure around one eye or temple. They may also begin as a burning sensation on the nose. The pain quickly intensifies over several minutes, eventually spreading to that side of the face. A cluster headache is often described as constant, deep, excruciating pain, although occasionally it may be pulsatile and throbbing. The pain is always on one side of the head.
The intense pain of a cluster headache often compels the victim to pace the floor or rock in a chair. This differs from a migraine attack, where the person wants to curl up into bed and be still.
Other symptoms of cluster headaches may include:
- Stuffed and runny nose
- Droopy eyelid
- Sweating forehead
- Pale appearance
- Red, tearing eye
- Nausea.
Diagnosing Cluster Headaches
In order to diagnose cluster
headaches, your healthcare provider will ask a number of questions about the headache, such as how often you have headaches or where the pain is. He or she will also ask about other symptoms that you may experience.
Your healthcare provider will also perform a physical exam, looking for signs of conditions known to cause headaches. If your healthcare provider is unsure of the diagnosis, he or she may also order tests to rule out other more serious
causes of headaches.
Treatment Options for Cluster Headaches
There are many different treatment options for cluster headaches based on their frequency, severity, and level of disability.
In general, your healthcare provider may recommend one or several different treatment options, including:
- Lifestyle changes
- Medications for an acute attack
- Preventive medications.
In chronic cases of cluster headaches, certain facial nerves may be surgically cut or destroyed to provide relief. These procedures have had limited success.
(Click Cluster Headache Treatment to learn about specific medicines used to stop an attack, along with medicines used to prevent cluster headaches in the first place.)
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