Cluster Headache Information

Cluster headache refers to the characteristic grouping or clustering of headache attacks. Cluster headaches are rare types of headaches that can cause severe one-sided head pain that reoccur in groups or clusters over a period of weeks to months. The condition only affects 1% of the population, and affects men more often than women. Cluster headaches are more common in adolescence and middle age, but can appear at any age.

The pain of a cluster headache is extremely severe but the attack is brief, the pain peaks in about 5 min and may last no more than 3 hours. The pain centers behind or around one eye, and the eye and nose on the same side as the pain may become inflamed and watery. Frequently occurring at night, cluster headaches also cause restlessness. They typically occur at the same time each day for several months, called “cluster periods.” These may last 4 to 8 weeks and may occur every few months. Other times you might have cluster-free periods where you experience no pain at all.

Although cluster headache attacks are extremely painful, they are not life-threatening.

Often alcohol triggers the attacks, if you have a history of heavy smoking or drinking consult your doctor.

Cause Of Cluster Headache

The cause of a episodic cluster headaches is still unknown. It may be a genetic condition. People whose parents or siblings endure them are at increased risk of developing them also.

Cluster headaches may be caused by a problem in an area of the brain called the hypothalamus, the autonomic or “automatic” nervous system. These systems play a role in rhythmic or cyclical functions in your body. Studies indicate that during periods of cluster headache, melatonin and testosterone are at abnormal levels. These hormonal changes are believed to be due to a problem with the hypothalamus. Cluster headache attacks typically occur with clock-like regularity during a 24-hour day and often follow the seasons of the year. These patterns suggest that the body’s biological clock, which resides in the hypothalamus, is involved. Other studies reveal that participants with cluster headaches have increased activity in the hypothalamus, compared with that of participants who don’t experience this headache. Nevertheless, it remains unknown what causes these abnormalities in the first place.

If you are prone to cluster headaches, certain triggers may cause a headache or make one worse. These triggers often include:

• Alcohol – Once a cluster period begins, consumption of just one drink of alcohol can trigger a splitting headache within minutes. Many people stay completely away from alcohol for the duration of a cluster period.
  
  
• Smoking – Inhaling nicotine can also trigger the headaches and make them worse.
  
  
• Fatigue – When normal sleep patterns are disrupted, such as during a vacation or when starting a new job or work shift, cluster headaches arise. Some people with the condition also have sleep apnea, where a person regularly stops breathing during sleep.
  
  
• Medication – Certain medications that widen blood vessels (vasodilators) such as nitroglycerin or histamine may trigger cluster periods. These are in drugs used to treat heart disease.

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Cluster Headache Symptoms

The most significant and dramatic cluster headache symptom is its severe pain. The pain strikes quickly, often without warning. Within minutes you may develop sharp, penetrating or burning sensations on the side of your nose or deep in your eye. Some patients describe the feeling as having an ice pick or a burning red poker driven through your eye. The affected eye might become red, watery, or puffy. The eyelid may droop, and you may have a stuffy or runny nasal passage in the nostril on the affected side of the face.

Typically the pain develops on the same side of the head throughout the cluster period, and often the headaches remain on that side throughout a person’s life.

People who suffer from cluster headaches may appear restless. The headaches occasionally attack at night, within 2 to 3 hours of falling asleep. They may occur within minutes of falling asleep in a compressed sleep cycle, or when you start to dream. Some people try to remain awake for as long as possible to forestall the onset of the headache, unfortunately doing so only speeds up the sleep cycle. This can lead to sleep deprivation, depression and stress.

Many people with cluster headaches prefer to be alone when suffering an attack. They may pace or sit and rock back and forth to soothe the attack. They may scream, bang their heads against the wall or hurt themselves to cause a distraction from the pain.

Chronic Cluster Headaches

Cluster headaches can be chronic, in that they continue for days, weeks, or months before you stop experiencing symptoms. Amazingly, the starting date and the duration of each cluster period are often consistent from period to period. For many patients, cluster periods occur seasonally, such as every winter or summer. Most attacks occur in January and July, when we experience the longest and shortest days of the year.

Symptoms of cluster headaches might include:

• Headaches that come on suddenly without warning.
  
  
• Pain that is severe, excruciating, piercing, burning, or sharp. May be described as if a red hot poker was being stabbed in the eye.
  
  
• Pain that affects only one side of the face, head, and neck.
  
  
• Pain that remains on the same side during a series.
  
  
• Pain can occur on the opposite side when a new series starts.
  
  
• Pain is localized behind the eye or in the eye region and may radiate to the forehead, temple, nose, cheek or upper gum.
  
  
• A watery, red eye that may become swollen or droop and the pupil may contract.
  
  
• A runny or stuffy nose on the affected side of the head.
  
  
• Headache that emerges after you have been asleep for a few hours.
  
  
• Excessive sweating, sometimes the forehead sweats.
  
  
• Face may become warm and flushed on the affected side.

Diagnosis

If you experiencing any symptoms of cluster headaches, visit your doctor for a diagnosis. Your physician will take a medical history and give you a physical examination. You will need to describe the type and location of the pain, duration and pattern of headaches, and how frequent they occur in order to get an accurate diagnosis.

Your doctor will want to rule out a variety of other causes of pain besides cluster headaches. If this is your first experience with such a severe pain, it might be a warning of subarachnoid hemorrhage or bleeding in your head or brain. This is a neurological emergency that will need to be treated right away in order to prevent death. In rare cases, the severe pain may be the result of a brain tumor or infection in your head. Your doctor may order imaging tests, such as an MRI or CT scan, in order to rule these out.

Cluster Headache Treatment and Medication

Although there is no cluster headache cure, treatments may help reduce the frequency of attacks and the severity of pain. It may shorten the headache period. Medications are available which may prevent/reduce the pain or prevent a cycle from getting worse once it starts. Click here to find medications for headache treatment.

Because the pain of cluster headaches comes on so suddenly and may subside within a short time, over-the-counter medications such as aspirin or ibuprofen aren’t effective. The headache is usually gone before the drug starts working.

Other effective treatments include the use of high-flow oxygen through a mask (breathing in pure oxygen relieves cluster headache pain almost immediately – within 10 to 20 minutes) or using a local anesthetic (numbing medicine) in your nose.

You may also reduce the frequency of cluster headaches by avoiding triggers such as alcohol, smoking, stress, and maintaining a regular sleep schedule.

Some find that by exercising they can relieve the pain. Jogging in place, push-up, or sit-ups can all help.

Prevention

During a cluster period, it is important to keep to your usual routine, remain clam and avoid changes in your sleep pattern. Once a cluster period starts, a change in normal daily routines may cause the symptoms to arise. Follow these tips to help avoid a cluster attack:

• Keep a regular sleep schedule. Cluster periods often begin when there are changes in your normal sleep schedule, something as simple as taking an afternoon nap can bring on the headaches.
  
  
• Avoid alcohol. Alcohol, including beer and wine, triggers cluster attacks almost immediately, even before you finish the first drink. Alcohol should be avoided completely until the cluster period is over.
  
  
• Limit exposure to volatile substances. Prolonged exposure to substances may trigger an attack; these may include solvents, gasoline and oil-based paints.
  
  
• Avoid high altitudes. The reduced oxygen at altitudes over 5,000 feet may trigger a headache.
  
  
• Avoid tobacco products. Nicotine and other tobacco products may trigger a headache during a cluster period. It’s suggested that you stop smoking and avoid such products.
  
  
• Avoid glare and bright lights. For some people, excessive glare, bright lights, or strobe lights might cause a headache.
  
  
• Avoid stress. Stress may bring on attacks. The headaches may start when you are relaxing after a stressful time.

Read more about cluster headaches.

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