Cluster Headaches

What are Cluster Headaches?

Cluster headaches are a category of headaches that occur in a cyclical pattern. A person afflicted with cluster headaches is primarily characterized by a series of headaches that occur episodically.

 

These episodes of cluster headaches are relatively short, but they are also one of the most painful categories of headaches. The defining characteristic of cluster headaches is their seasonal nature. Episodes of cluster headaches tend to occur around the same time every year.

 

The duration of these almost uniformly frequent bouts of cluster headaches can range from weeks to months to entire seasons.

 

This duration of time is clinically referred to as a cluster period. Every cluster period is followed by a period of remission, during which time the patient does not experience any headaches.

 

These periods of remission can range from as short as a week to as long as a year or sometimes even more.

 

Cluster headaches are the least common form of headaches. In an average sample space of one thousand people, only one person is potentially likely to be afflicted by cluster headaches, in other words, the probability of a person being afflicted by cluster headaches is less than one in one thousand.

 

People under the age of thirty are more prone to cluster headaches. Men are found to be more susceptible to cluster headaches than women.

 

Causes & Triggers For Cluster Headaches

Unlike migraine headaches and tension headaches, cluster headaches are not commonly triggered by external factors such as food habits, sleep deprivation, stress, fatigue or depression. Here are some internal factors that can cause cluster headaches to occur and some external ones that can aggravate the patient’s condition:

 

  • The exact mechanism or physiological abnormality that triggers a cluster headache remains yet unknown. However, it is more or less accepted by physicians that the culprit here is a facial nerve, which possibly malfunctions around either one eye, and causes an extreme sensation of pain in that region. This pain then spreads out to the rest of the head.

 

 

  • Owing to the periodic pattern of these cluster headaches, it is easy to conclude that cluster headaches have got something to do with the internal biological clock of the human body. This concerns the Hypothalamus portion of the brain, which controls the sleep-wake cycle of a human being. An anomaly in a neural pathway of the hypothalamus can cause the Trigeminal nerve to malfunction. This nerve is rooted in one’s eye and is responsible for feelings such as heat or pain.

 

 

  • Once a person starts experiencing episodes of cluster headaches, they are generally advised to stay away from alcohol as it can aggravate the frequency and intensity of the headaches. Smokers are also observed to be more vulnerable to cluster headaches, even though a direct link has not been established.

 

 

  • Some drugs can also make the user more susceptible to cluster headaches. An example of this is the drug Nitroglycerine, which is generally prescribed to people suffering from heart diseases.

 

 

  • A person’s ancestry and family history also play a role in the level of their vulnerability to cluster headaches. A person who has immediate family members and next of kin that may be suffering from cluster headaches has a higher chance of experiencing cluster headaches themselves during their lifetime.

What are the symptoms for Cluster Headaches?

 

The symptoms for cluster headaches are rather obvious and well-defined than those pertaining to tension headaches. Cluster headaches are very unpredictable and don’t come with any warning symptoms, unlike migraine headaches. The symptoms are often intense and rather excruciating. They include:

 

1. Excessive pain behind either one eye. This pain eventually spreads over the entire face.

 

2. Inflammation and redness of the affected eye. Swelling may also be observed.

 

3. Leakage of water from the affected eye.

 

4. The nostril on the side of the affected eye being stuffy.

 

5. Sweating on the affected side of the forehead.

 

6. Restlessness, nausea, and vomiting.

What is the diagnosis & treatment for Cluster Headaches

 

Diagnosis For Cluster Headaches

 

Some of the measures through which physicians test a patient for cluster headaches include:

 

  • Detailed history is the key to the diagnosis.

 

  • Neurological examination: The physician will examine the patient’s brain function, senses, and reflexes using a series of clinical procedures. This is necessary to detect any neurological anomalies that the patient may be afflicted with.

 

  • Imaging Tests: In case some abnormality is detected in the patient’s neurology, the physician will perform imaging tests on the patient’s brain to rule out any possibilities of potentially fatal conditions such as brain tumors and aneurysms. These tests include MRI and CT scans.

 

Treatment of Cluster Headaches

 

Here are some of the common remedial measures for cluster headaches as prescribed by physicians:

 

  • The most common treatment for cluster headaches involves inhalation of Oxygen. Oxygen provides relief for cluster headaches and is a very safe medicational tool. The only drawback to this remedial measure is the fact that the patient has to carry an oxygen cylinder at all times.

 

  • Some neuralgic pain killer medication can be administered to help patients suffering from cluster headaches. These drugs may occasionally need to be injected into the patient’s bloodstream. They include Injectable sumatriptan (Imitrex), Dihydroergotamine and Octreotide.

 

  • Certain medications are also available which can prevent or reduce frequency of a cluster headache attack.

 

  • Local anesthetics can also be administered in the form of nasal drops.

Dr. Dwaipayan Sen (FRCP(Glasgow) MRCP Geriatrics)


Consultant Stroke Physician, UK

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