What are cluster headaches?

Migraine headaches are a neurological symptom often characterized by an altered perception of the body accompanied by nausea and headaches.  Sometimes these headaches happen only on one side of the head and often they are preceded by a visual disturbance or aura.

A cluster headache is one of the most painful types of migraine headaches.  These headaches usually occur in a cyclical pattern or cluster, which gives them their name.  The period of time during which the attacks happened can last for weeks to months and will be followed by a remission.  The pattern will vary from person to person, but most have at least one cluster period a year.  During a remission the individual will experience no headache for several months and sometimes even in years.

The cluster headache is far less common than a migraine headache or a tension headache.  They also begin far more dramatically and are quite unique in the way in which they present themselves.  In contrast to people who suffer from migraine headaches, about five to eight times as many men as women have the cluster headache.  Most people can pinpoint their first cluster headache at around 25 years of age but some experience their first attack anywhere from their teens to their early 50s.  

There are two different types of cluster headaches.  The first is episodic and is much more common of this rare condition.  People will suffer from two or three different headaches  a day for about two months and then not experienced anything for about a year.  At that point the pattern repeats itself.  A chronic cluster headache behaves very similarly but, unfortunately, there is no period of untreated sustained relief.

A cluster headache will strike quickly and usually without warning.  Typically the individual will suffer from excruciating pain located in or around the eye but it may also radiate to other areas of the face.  The pain is one sided in the person will also experience excessive tearing, redness in the eye, stuffy or runny nasal passage and sweaty pale skin on the face.  Sometimes there is swelling around the eye on the affected side of the face.

The pain is often described as sharp, penetrating or burning and it feels this is there is a hot poker being stuck in their eye.  People suffering from a cluster headache will also appear restless and prefer to pace or rock back and forth to soothe the attack.  They may also experience other migraine like symptoms such as nausea, sensitivity to light and sound and possibly an aura.

Many experts believe the cluster headaches and migraine headaches share a common cause but it is a belief and not a theory that has been upheld by research.  The theory is that a nerves carrying sensation from the head to the brain which in to surround the brain is irritated.  Others believe that the pain comes from a deep vascular channel in the head and does not involve the trigeminal nerves.

If you start to experience cluster headaches you should see your primary care physician to rule out other medical issues and to find the most effective treatment.  Headaches that start with a sudden thunderclap or are accompanied by fever, stiff neck, mental confusion are not cluster headaches and should be evaluated by your physician immediately.  A sudden and severe headache unlike anything you've ever experienced before or a headache after a head injury, even if it's a minor fall or a bump should also be evaluated immediately.

Treatment does not usually cure cluster headaches, instead the goal is to relieve the symptoms or assist in preventing them from occurring.  Smoking, alcohol, specific foods and other personal triggers seem to precipitate cluster headaches and should be avoided.  By keeping a diary you can help identify what may have triggered the headache.  The diary should include notes about what was eaten and drunk in the last 24 hours as well is how much you slept and what was going on immediately prior to the pain beginning.

Treatment may involve methods to treat the pain when it happens or medicines used to prevent the headache in the first place.  Your physician may recommend several weeks of anti-inflammatory medications or breathing 100% oxygen to relieve the pain, especially for those that occur at night.  Straight pain killers do not usually relieve the pain from a cluster headache because they take too long to work.  Those that may help are ergot preparations or methysergide maleate.  These drugs can have severe side effects and should only be used when needed.

Some patients have found prevention relief by using antihistamines, lithium, calcium channel blockers, propranolol, amitriptyline, verapamil and indomethacin.

As is the case with other migraine type headaches, individuals who suffer from cluster headaches may respond to different therapies that are available in becoming less expensive.  With the proper medical treatments, identifying potential triggers and using appropriate pain killers you are often able to control cluster headaches to the point where they do not interfere significantly with your daily life.

RESOURCES

MayoClinic: Cluster Headache
http://www.mayoclinic.com/health/cluster-headache/DS00487

MedlinePlus: Cluster Headache
http://www.nlm.nih.gov/medlineplus/ency/article/000786.htm

National Headache Foundation: Cluster Headaches
http://www.headaches.org/education/Headache_Topic_Sheets/Cluster_Headaches

University of California San Francisco: Cluster Headaches
http://www.ucsfhealth.org/conditions/cluster_headaches/index.html

University of Maryland Medical Center: Cluster Headaches
http://www.umm.edu/patiented/articles/what_a_cluster_headache_000099_2.htm

Michigan Headache and Neurological Institute: Cluster Headaches
http://www.mhni.com/headache-pain-faq/cluster-headaches

American Headache Society: Cluster Headache http://www.achenet.org/resources/cluster_headache/