Definition
Cluster headaches affect one side of the head (unilateral) and may involve tearing of the eyes and a stuffy nose. The headaches occur repeatedly every day at the same time for several weeks and then go away.
Symptoms
- Swelling under or around the eyes (usually one eye, on the same side as the head pain)
- Excessive tears (on the affected side)
- Red eye (on the affected side)
- Rhinorrhea (runny nose) or nasal congestion (typically occurs on only one side of the nose, the same side as the head pain)
- Red, flushed face
- Headache
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Definition
Cluster headaches affect one side of the head (unilateral) and may involve tearing of the eyes and a stuffy nose. The headaches occur repeatedly every day at the same time for several weeks and then go away.
Symptoms
- Swelling under or around the eyes (usually one eye, on the same side as the head pain)
- Excessive tears (on the affected side)
- Red eye (on the affected side)
- Rhinorrhea (runny nose) or nasal congestion (typically occurs on only one side of the nose, the same side as the head pain)
- Red, flushed face
- Headache
- Begins suddenly
- Commonly begins 2 to 3 hours after falling asleep
- Steady, sharp pain
- Burning or boring pain
- Characteristically occurs on one side of the head
- May occur in and around one eye
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Causes
Cluster headaches are a fairly common form of chronic , recurrent headache . Unlike migraines , they affect men more often than women. They can affect people of any age but are most common between adolescence and middle age. There does not seem to be a pattern among families in the development of cluster headaches.
A cluster headache begins as a severe, sudden headache. No specific cause has been found for the disorder, but it appears to be related to a sudden release of histamine or serotonin by body tissues.
The onset is sudden, and it happens most commonly during the dreaming (REM) phase of sleep. 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). A person may experience alternating chronic and episodic phases.
Some people who experience cluster headaches are heavy smokers. Alcohol use may trigger attacks. ...
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Treatment
Treatment does not cure cluster headaches. The goal of treatment is to relieve symptoms. Spontaneous remission may occur, or treatment may be required to prevent headaches.
Smoking, alcohol use, specific foods, and other factors that seem to trigger cluster headaches should be avoided.
A headache diary may be helpful to identify such triggers. When a headache occurs, record the date and the time, list any activities, substances used or consumed within the previous 24 hours, and any other factors that seem significant.
Analgesic medications do not usually relieve the pain from cluster headaches. Generally, they take too long to work -- the headache is usually gone before they take effect.
Inhalation of 100% oxygen often relieves cluster headache for some people, particularly for frequent cluster headaches ...
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Other Names
Histamine headache; Headache - histamine; Migrainous neuralgia; Headache - cluster
Possible Complications
- Interference with lifestyle
- Side effects of medications (see the specific medication)
- Permanent muscle weakness in parts of the face or head after surgery
- Decreased sensation in parts of the face or head after surgery
- Horner's syndrome (not a medical problem, but can be distressing due to cosmetic effects)
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Outlook (Prognosis)
Cluster headaches are not life-threatening and usually cause no permanent structural changes. However, they are chronic and may be painful enough to be debilitating as they are happening, and this may interfere with work or lifestyle. Occasionally, the pain may be severe enough to drive some individuals to attempt suicide. Side effects of medications or surgery may be severe.
Prevention
If prone to cluster headache, stop smoking. Alcohol use and any foods that are associated with cluster headache may need to be avoided. Medications may prevent cluster headaches in some cases.
Exams and Tests
Cluster headaches may be diagnosed by your health care provider based on the symptoms and a physical examination. Tests may be required to rule out other causes of the symptoms. Examination usually shows no specific neurologic effects except for Horner's syndrome (one-sided eyelid drooping or small pupil) during an attack that is not present between episodes. This can evolve into persistent Horner's syndrome.
An MRI of the head may be done to rule out other pathology.
