Cluster headache | |
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Trigeminal nerve | |
Specialty | Neurology |
Symptoms | Recurrent, severe headaches on one side of the head, eye watering, stuffy nose[1] |
Usual onset | 20 to 40 years old[2] |
Duration | 15 minutes to 3 hours[2] |
Types | Episodic, chronic[2] |
Causes | Unknown[2] |
Risk factors | Tobacco smoke, family history[2] |
Diagnostic method | Based on symptoms[2] |
Differential diagnosis | Migraine, trigeminal neuralgia,[2] other trigeminal autonomic cephalgias[3] |
Prevention | Verapamil, galcanezumab, oral glucocorticoids, steroid injections, civamide[4] |
Treatment | Oxygen therapy, triptans[2][4] |
Frequency | ~0.1% at some point in time[5] |
Cluster headache is a neurological disorder characterized by recurrent severe headaches on one side of the head, typically around the eye(s).[1] There is often accompanying eye watering, nasal congestion, or swelling around the eye on the affected side.[1] These symptoms typically last 15 minutes to 3 hours.[2] Attacks often occur in clusters which typically last for weeks or months and occasionally more than a year.[2]
The cause is unknown,[2] but is most likely related to dysfunction of the posterior hypothalamus.[6] Risk factors include a history of exposure to tobacco smoke and a family history of the condition.[2] Exposures which may trigger attacks include alcohol, nitroglycerin, and histamine.[2] They are a primary headache disorder of the trigeminal autonomic cephalalgias type.[2] Diagnosis is based on symptoms.[2]
Recommended management includes lifestyle adaptations such as avoiding potential triggers.[2] Treatments for acute attacks include oxygen or a fast-acting triptan.[2][4] Measures recommended to decrease the frequency of attacks include steroid injections, galcanezumab, civamide, verapamil, or oral glucocorticoids such as prednisone.[6][4][7] Nerve stimulation or surgery may occasionally be used if other measures are not effective.[2][6]
The condition affects about 0.1% of the general population at some point in their life and 0.05% in any given year.[5] The condition usually first occurs between 20 and 40 years of age.[2] Men are affected about four times more often than women.[5] Cluster headaches are named for the occurrence of groups of headache attacks (clusters).[1] They have also been referred to as "suicide headaches".[2]
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