Description

Cluster headache is a very painful type of headache. It usually occurs in periods of frequent attacks, known as clusters. Cluster headaches can awaken people from their sleep. These headaches cause intense pain in or around one eye on one side of the head.

Periods of attacks can last from weeks to months. Then, typically, the headaches stopped for a period of time, which can last for months or years.

Cluster headache is rare. The treatments can reduce the attacks of cluster headache and decrease pain. Also, there are medications that can reduce the number of cluster headaches.

Symptoms

Common symptoms

A cluster headache strikes quickly. There are usually no warning. But some people may have to first have the migraine, such as nausea and aura. The common symptoms during a cluster headache are:

  • End sharp or stabbing pain, usually in, behind or around one eye. The pain can spread to other areas of the face, head, and neck.
  • Pain in one side of the head in a single group. The pain may switch to the other side in another cluster.
  • Concern.
  • A lot of tears.
  • Redness of the eye on the side that hurts.
  • Stuffy or runny nose on the side that hurts.
  • The front or face of the sweating.
  • The color of the skin changes on the side of the face, it hurts.
  • Swelling around the eye on the side that hurts.
  • Drooping eyelid on the side that hurts.

Because the pain of a cluster headache can be so bad, who has one of probably the pace, or sit and rock back and forth.

Cluster periods

A cluster period usually lasts from several weeks to several months. Each cluster period may start at the same time of the year and the last about the same length of time. For example, the cluster periods may come during certain seasons of the year, as every spring or every autumn.

For most people with cluster headaches, cluster period lasts from a week to a year. Then is there a pain period, known as the referral, for three or more months before the next cluster headache comes. This is known as episodes of cluster headache.

Cluster periods may continue for more than a year. Pain-free periods may last for less than a month. If a cluster period lasts for one year continuously, it is called chronic cluster headache.

During a cluster period:

  • The headaches tend to come every day, often several times a day.
  • An attack can last from 15 minutes to three hours, but most often lasts 30 to 45 minutes.
  • The attacks tend to occur at the same time each day.
  • Most attacks occur at night, usually 1 to 2 hours after bedtime.

The pain usually ends as soon as it begins. After the attacks, the majority of people are free of pain, but out of stock.

When to see a doctor

See a health care provider if you are just starting to have cluster headaches. Your healthcare provider can rule out other diseases and suggest treatment.

Even bad for the headache is usually not the result of another illness. But sometimes headaches can mean a serious medical condition. This can be a brain tumor or rupture of a weakened blood vessel, known as the dissection.

Also, if you have a history of headaches, see your health care provider if there is a change in how they feel, or how often they occur.

Seek emergency medical attention if you have any of these symptoms:

  • A severe headache that comes on all of a sudden, often as a clap of thunder.
  • A headache, fever, nausea or vomiting, stiff neck, confusion, seizures, numbness or difficulty speaking. These might point to a stroke, meningitis, encephalitis, brain tumor or other problems.
  • A headache after a head injury, especially if it gets worse — even if the injury was a minor fall or bump.
  • A sudden, severe headache unlike any other.
  • A headache that gets worse throughout the day and changes in the pattern.

Causes

Experts do not know what causes cluster headache. Cluster headache patterns suggest a link to the area of the brain that allows the body's biological clock, known as the hypothalamus.

Cluster headache triggers

There are several cluster headache triggers. The most common is the consumption of alcohol. Other triggers can include changes in time and certain medications.

Risk factors

Risk factors for cluster headache are:

  • Sex. Men are more likely to have cluster headaches than women.
  • Age. The majority of people who get cluster headaches are between the ages of 20 and 50. But the condition can begin at any age.
  • The habit of smoking. Many people who get cluster headaches are smokers. But quitting does not usually stop the headaches.
  • The consumption of Alcohol. If you have cluster headaches, the consumption of alcohol during a cluster period may increase the risk of an attack.
  • The history of the family. Having a parent, brother or sister who has cluster headache may increase the risk.

Diagnosis

Cluster headache has a certain type of pain, and the pattern of the attacks. A diagnosis depends on describe the pain, where the pain is, how bad it is and other symptoms. How often headaches come and how long they last are also important.

For cluster headache, a specialist trained in treating headaches (neurologist), makes a diagnosis in the medical history, symptoms, and a physical and neurological examination.

For people with unusual or complicated headaches, tests to rule out other causes of pain may include:

  • A magnetic resonance imaging. A magnetic resonance imaging (MRI) uses a powerful magnetic field and radio waves to produce detailed images of blood vessels, and brain. MRI scans help diagnose tumors, strokes, brain hemorrhages, infections, and other brain and nervous system diseases. Conditions that affect the brain and the nervous system are also known as neurological diseases.
  • A computed tomography scan. A computed tomography (CT) scan uses a series of X-rays to create detailed cross-sectional images of the brain. This helps to diagnose tumors, infections, brain damage, bleeding in the brain and other possible medical problems that can cause headaches.

Treatment

There is No cure for cluster headaches. The goal of treatment is to reduce pain, shorten the period of pain and prevent further attacks.

Because the pain of a cluster headache tends to come suddenly and disappear quickly, it can be difficult to treat. The treatment requires the rapid action of the medicines.

Fast-acting treatments

These treatments aim to stop a cluster headache once it has started:

  • Oxygen.The breathing of pure oxygen through a mask provides relief for the majority of those who use it. People feel the effects of this treatment safe within 15 minutes. Oxygen generally has no side effects. But it is not used for people with severe chronic obstructive pulmonary disease.
  • The triptans.Sumatriptan (Imitrex) is given as a shot when the head group of the onset of symptoms. The use of sumatriptan as a nasal spray or by using another triptan medicine, zolmitriptan (Zomig), it has also been shown that it works, but not as quickly as a shot. Sumatriptan is not recommended for people who have uncontrolled high blood pressure or heart disease. The shots and nasal sprays are the most commonly used oral medications, because they act faster than the medicines taken by mouth to do.
  • Octreotide. Octreotide (Sandostatin), a shot of a version of the brain of the hormone somatostatin, it works for some people with cluster headache. It can be used by people for whom triptans don't work well.
  • Local anesthetics. The numbing effect of the local anesthetics such as lidocaine, may work against of cluster headache in some people when administered through the nose.
  • Dihydroergotamine. A form of this medication through a vein could help to relieve the pain in some people with cluster headache. This medication also comes in a form that is inhaled through the nose. But this form has not been proven to work for the group head.

Oxygen. The breathing of pure oxygen through a mask provides relief for the majority of those who use it. People feel the effects of this treatment safe within 15 minutes.

Oxygen generally has no side effects. But it is not used for people with severe chronic obstructive pulmonary disease.

The triptans. Sumatriptan (Imitrex) is given as a shot when the head group of the onset of symptoms. The use of sumatriptan as a nasal spray or by using another triptan medicine, zolmitriptan (Zomig), it has also been shown that it works, but not as quickly as a shot.

Sumatriptan is not recommended for people who have uncontrolled high blood pressure or heart disease.

The shots and nasal sprays are the most commonly used oral medications, because they act faster than the medicines taken by mouth to do.

Preventive treatments

Preventive therapy is initiated at the onset of the cluster period with the aim of stopping the attacks. Once the episode of cluster headache ends, a health care provider helps you to gradually stop taking the medicine.

  • Calcium channel blockers.The agent channel blocker of calcium, verapamil (Calan SR, Verelan) is often the first choice for the prevention of cluster headache. Verapamil can be used with other medicines. Sometimes, the use for a longer time is needed to manage chronic cluster headache. Most of the people you may take verapamil with no problems. But the side effects can include constipation, nausea, tiredness and irregular beating of the heart.
  • Corticosteroids.These medications, such as prednisone (Prednisone Intensol, Rays), to act quickly to relieve cluster headaches. That could be used by people who do not have cluster headache often, and whose episodes are short. These medications may be useful for the relief until long-term medication to start to work. It is often used with verapamil. Corticosteroids might be good to use for several days. But they can cause serious side effects if used long-term. The side effects can include diabetes, high blood pressure and osteoporosis.
  • Galcanezumab (Emgality). The Food and Drug Administration recently approved this drug for the treatment of episodes of cluster headache. Whether as a monthly trip to the cluster that period ends.
  • Lithium (Lithobid).This medication is used to treat bipolar disorder. That could help prevent long-life, known as chronic cluster headache. It's used for people who cannot take other medicines or other medicines have not worked. The side effects include tremor, increased thirst and kidney problems. Taking this medicine it means to have regular blood tests and other tests to check for serious side effects.
  • Non-invasive vagus nerve stimulation (VNS). Non-invasive VNS uses a hand-held controller to send electrical stimulation of the vagus nerve through the skin. Although more research is needed, some studies have found that the VNS helped to reduce the frequency of headaches.
  • Blockade of the nerves.This consists of an injection of medication to alleviate the pain in the back of the head. The drug enters an area of around a nerve known as the occipital nerve. The injection can include a numbing medication, known as an anesthetic and a corticosteroid. An occipital nerve block may be useful for the relief until long-term medication to start to work. Often used in combination with verapamil.

Calcium channel blockers. The agent channel blocker of calcium, verapamil (Calan SR, Verelan) is often the first choice for the prevention of cluster headache. Verapamil can be used with other medicines. Sometimes, the use for a longer time is needed to manage chronic cluster headache.

Most of the people you may take verapamil with no problems. But the side effects can include constipation, nausea, tiredness and irregular beating of the heart.

Corticosteroids. These medications, such as prednisone (Prednisone Intensol, Rays), to act quickly to relieve cluster headaches. That could be used by people who do not have cluster headache often, and whose episodes are short.

These medications may be useful for the relief until long-term medication to start to work. It is often used with verapamil.

Corticosteroids might be good to use for several days. But they can cause serious side effects if used long-term. The side effects can include diabetes, high blood pressure and osteoporosis.

Lithium (Lithobid). This medication is used to treat bipolar disorder. That could help prevent long-life, known as chronic cluster headache. It's used for people who cannot take other medicines or other medicines have not worked.

The side effects include tremor, increased thirst and kidney problems. Taking this medicine it means to have regular blood tests and other tests to check for serious side effects.

Blockade of the nerves. This consists of an injection of medication to alleviate the pain in the back of the head. The drug enters an area of around a nerve known as the occipital nerve. The injection can include a numbing medication, known as an anesthetic and a corticosteroid.

An occipital nerve block may be useful for the relief until long-term medication to start to work. Often used in combination with verapamil.

Other preventive medications used for cluster headache, which include anti-epileptic drugs, such as topiramate (Topamax, Qudexy XR).

Surgery

Rarely, surgery may help people with chronic headaches that don't get relief from other treatments.

Some surgeries to the group head to try to damage nerve pathways that are believed to cause the pain.

However, the long-term benefits of these surgeries are uncertain, and the complications can be serious. They include muscle weakness in the jaw and the loss of sensation in some parts of the face and head.

Potential future treatments

Researchers are studying other ways to treat cluster headache, including a series of procedures that stimulates the nerves. These include sphenopalatine ganglion stimulation, stimulation of the occipital nerve and deep brain stimulation.

These procedures involve the placement of a device in certain areas of the brain that can send an electrical signal to the area to block pain. These procedures have shown to be promising in the treatment of cluster headache. More studies are needed.

Lifestyle and home remedies

To avoid a cluster headache attack during a cluster period, try the following:

  • Stick to a regular sleep schedule. During a cluster period, does not change when and how long you sleep. Changes in sleep can trigger cluster headaches.
  • Avoid the consumption of alcohol. The consumption of alcohol, including beer and wine, you can trigger a headache during a cluster period.

Alternative medicine

A hormone, melatonin, which affects the body clock could help in the relief of cluster headache attacks. A chemical in chili peppers, capsaicin, which is used in the interior of the nose, could reduce the frequency of cluster headache attacks occur and how bad they are. Talk with your health care provider before using any alternative treatment.

Coping and support

Living with cluster headache can be difficult. Have cluster headache attacks can affect relationships, work and quality of life.

Speak with a counselor or therapist can help. A headache support group can help you get the support and information. Your health care provider may be able to suggest a therapist or a support group in your area.

Preparing for your appointment

It is likely to start by seeing your primary care provider. However, you may be referred to a neurologist.

Here's some information to help you prepare for your appointment.

What you can do

When you make the appointment, ask if there is something that you need to do before it, such as fasting for certain tests.

Keep a diary of headache

One of the most helpful things you can do is to keep a pain diary. Each time you get a headache, please keep in mind these details that will give to your health care provider information to assist with diagnosis:

  • Date. In the cartography of the date and time of each headache may help you see patterns.
  • Duration. How long does each headache for the last time?
  • Intensity. The rate of your headache pain on a scale of 1 to 10, with 10 being the worst case.
  • Triggers. List of possible triggers that might have caused your headache, such as certain foods, sounds, smells, physical activity, or sleep too much.
  • Symptoms. Do you have symptoms before the headache, such as aura?
  • Drugs. List of all the medicines, vitamins, and supplements you are taking, including dosage.
  • The relief. Have you had any pain relief? How much or how little?

Have a family member or friend to your appointment, if possible, to help you remember the information that is obtained.

List of questions to ask your doctor. For cluster headaches, the basic questions are:

  • What is likely causing my symptoms?
  • What other possible causes are there?
  • What tests do I need?
  • Is my condition likely to disappear or to be of long duration?
  • What treatment do you recommend it?
  • I have other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • You should see a specialist?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Be sure to ask all the questions that you have.

What to expect from your doctor

Your doctor may ask you questions, such as:

  • When did your symptoms begin?
  • Do you have symptoms sometimes or all the time?
  • Did your symptoms tend to occur at the same time of day? Occur during the same season each year?
  • Does the alcohol seem to cause your symptoms?
  • How bad are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Cluster headache