Cluster headaches
| Cluster headache | |
|---|---|
 |
|
| Trigeminal nerve | |
| Classification and external resources | |
| Specialty | Neurology |
| ICD-10 | G44.0 |
| ICD-9-CM | 339.00,339.01,339.02, |
| DiseasesDB | 2850 |
| MedlinePlus | 000786 |
| eMedicine | EMERG/229 article/1142459 |
| Patient UK | Cluster headache |
| MeSH | D003027 |
Cluster headache (CH) is a neurological disorder characterized by recurrent, severe headaches on one side of the head, typically around the eye. There are often accompanying autonomic symptoms during the headache such as eye watering, nasal congestion and swelling around the eye, typically confined to the side of the head with the pain.
Cluster headache belongs to a group of primary headache disorders, classified as the trigeminal autonomic cephalalgias or (TACs). Cluster headache is named after the demonstrated grouping of headache attacks occurring together (cluster). Individuals typically experience repeated attacks of excruciatingly severe unilateral headache pain. Cluster headache attacks often occur periodically; spontaneous remissions may interrupt active periods of pain, though about 10–15% of chronic CH never remit. The cause of cluster headache has not been identified.
While there is no known cure, cluster headaches can sometimes be prevented and acute attacks treated. Recommended treatments for acute attacks include oxygen or a fast acting triptan. Primary recommended prevention is verapamil. Steroids may be used as a transitional treatment and may prevent attack recurrence until preventative treatments take effect. The condition affects approximately 0.2% of the general population, and men are more commonly affected than women, by a ratio of about 2.5:1 to 3.5:1.
Cluster headaches are recurring bouts of excruciating unilateral headache attacks of extreme intensity. The duration of a typical CH attack ranges from about 15 to 180 minutes. Most untreated attacks (about 75%) last less than 60 minutes.
The onset of an attack is rapid and most often without preliminary signs that are characteristic in migraine. Preliminary sensations of pain in the general area of attack, referred to as "shadows", may signal an imminent CH, or these symptoms may linger after an attack has passed, or even between attacks. Though CH is strictly unilateral, there are some documented cases of "side-shift" between cluster periods, extremely rare, simultaneously (within the same cluster period) bilateral headache.
The pain occurs only on one side of the head (unilateral), around the eye (orbital), particularly above the eye (supraorbital), in the temple (temporal), or in any combination. The pain of CH attack is remarkably greater than in other headache conditions, including severe migraine. The pain is typically described as burning, stabbing, boring or squeezing, and may be located near or behind the eye. Those with cluster headaches may experience suicidal thoughts during an attack as a result of the pain (giving the alternative name "suicide headache" or "suicidal headache"). It is reported as one of the most painful conditions.
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