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- Episodic cluster headaches—These occur one or more times daily for multiple weeks. The headaches then go away and come back months or years later.
- Chronic cluster headaches—These occur almost daily with headache-free periods lasting less than one month.
- Alcohol use
- Changes in barometric pressure
- Changes in sleep pattern
- Tobacco use
- Medications, such as nitroglycerin
- Prior head surgery or head injury
- Family history of cluster headaches
Stabbing, penetrating, burning, or explosive head pain that:
- Begins suddenly
- Is on one side of the head, but not both
- Often starts around the eye and spreads to the same side of the head
- Causes facial flushing
- Can occur daily or almost every day for multiple weeks
- Can occur 1-8 times per day
- Lasts 15 minutes to 3 hours
- Often occurs at about the same time each day
- May increase in intensity over time
- May start within two hours of going to sleep
- Can awaken you from sleep
- Causes an aura—This can include visual disturbance, visual spots, or the inability to move one side of the body.
- Restlessness and agitation
- Stuffy or runny nose
- Redness or watering of the eye on one side
- Droopy eyelid
- Constriction of the pupil of the eye
- Facial swelling and flushing, sweating
- Sensitivity to light and noise
|Symptoms of a Cluster Headache|
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- Mental status
- Cranial nerve functioning
- Motor and sensory functioning
- When your headaches started and ended
- What you were doing at the time
- What you tried to relieve the pain
Lifestyle Changes and Self-care
- Maintain the same sleep routine. Avoid afternoon naps or sleeping in, which may bring on more headaches.
- Do not drink alcoholic beverages. Even a small amount of alcohol can trigger a headache during a cluster period.
- Learn stress management techniques. Stress can bring on a headache.
- Do not smoke. Tobacco may interfere with medications.
- Find out what your triggers are and take steps to avoid them.
American Headache Society http://www.achenet.org
National Headache Foundation http://www.headaches.org
Headache Network Canada http://www.headachenetwork.ca
Help for Headaches http://www.headache-help.org
Beck E, Sieber WJ, et al. Management of cluster headache. Am Fam Physician. 2005; 71:717-724.
Cittadini E, May A, et al. Effectiveness of intranasal zolmitriptan in acute cluster headache. Arch Neurol. 2006;63:1537-1542.
Cluster headache. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated July 17, 2013. Accessed November 16, 2013.
Finocchi C, Del Sette M, et al. Cluster headache and right-to-left shunt on contrast transcranial Doppler: a case-control study. Neurology. 2004;63:1309.
Francis GJ, Becker WJ, et al. Acute and preventive pharmacologic treatment of cluster headache. Neurology. 2010;75(5):463-473.
Headache: hope through research. National Institute Of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/headache/detail%5Fheadache.htm#193263138. Updated November 8, 2013. Accessed November 16, 2013.
Leone M, Bussone G. Pathophysiology of autonomic trigeminal neuralgias. Lancet Neurol. 2009;8(8):755-764.
Leroux E, Valade D, et al. Suboccipital steroid injections for transitional treatment of patients with more than two cluster headache attacks per day: a randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2011;10(10):891-897.
May A, Leone M, et al. EFNS guidelines on the treatment of cluster headache and other trigeminal-autonomic cephalgias. Eur J Neurol. 2006;13(10):1066-1077.
Russell MB, Anderson PG, et al. Familial occurrence of cluster headache. J Neurol Neurosurg Psychiatry. 1995;58:341-343.
Van Vliet JA, Bahra A, et al. Intranasal sumatriptan in cluster headache: randomized placebo-controlled double-blind study. Neurology. 2003;60:630-633.
10/25/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Francis GJ, Becker WJ, et al. Acute and preventive pharmacologic treatment of cluster headache. Neurology. 2010;75(5):463-473.
- Reviewer: Rimas Lukas, MD
- Review Date: 11/2013
- Update Date: 11/16/2013