Cluster Headache

What is a Cluster Headache?

A Cluster headache is a strong and sudden outburst of pain that only occurs along one side of the head. Most people experience it in the temple area and behind the eyes. These headaches cause some of the most severe pain experienced in this part of the body.

Unlike with migraines and many other types of intense headaches, men are more likely to experience these headaches than women. It’s unclear what causes these headaches, although some are linked to aneurysms deep in the brain. Most are not linked to any specific cause or underlying disease.

What are the Symptoms of a Cluster Headache?

There a many different symptoms of a cluster headache.

Symptoms include

  • The sudden onset of pain reaching full intensity within 10 to 15 minutes
  • Short bursts of pain between 15 minutes and 3 to 4 hours
  • Nasal drip and congestion
  • Reoccurring outbursts that can repeat multiple times a day or skip years at a time
  • Tearing and redness in the eye on the affected side of the head
  • A drooping eyelid or enlarged pupil

Cluster Headache Causes

While the specific mechanisms behind cluster headaches are largely unknown, there are many known factors that can increase their frequency and severity. There are some unavoidable factors that can influence a person’s susceptibility to cluster headaches, which include being over 30 years old, male, and/or having a family history of cluster headaches.

Regarding other risk factors, there are lifestyle habits that can significantly increase the chances of developing cluster headaches such as smoking and alcohol use. Substances that cause vasodilation, such as in the case of alcohol, can cause the development of many types of headaches, cluster headaches included. In regard to environmental causes, allergens triggering histamine release can bring on cluster headaches as well. Other triggering factors include the use of nitroglycerin in people who have heart disease, significant changes in activity level, and high stress levels.

How is a Cluster Headache Treated?

For life-threatening cases of coarctation of the aorta, emergency surgery is necessary to restore blood flow. A balloon angioplasty is the most common surgery used. A small balloon is used to stretch the aorta open again and leave a fine mesh stent behind to support it if necessary.

This procedure works for infants, children, and even adults who manage to go without a diagnosis at a younger age. Very mild cases may not need any treatment or all, or just medication to control the side effects. Most patients need high blood pressure medication for life, even after surgery.

Cluster Headache Prevention

Given the multifactorial nature of cluster headaches, there are many steps that can be taken to avoid their triggers. Reducing or eliminating alcohol intake is effective in reducing the frequency of cluster headaches given its role as a vasodilator. Other lifestyle changes including stress management can also help in preventing cluster headaches. If possible, avoiding certain allergens that trigger histamine release can be an effective way of heading off a cluster headache; however, it has not been shown that anti-histamine use has preventative effects.

Additionally, there are pharmacologic measures that can be taken to prevent cluster headaches, including corticosteroids and selective serotonin receptor agonists. Calcium channel blockers have also been effective in helping prevent cluster headaches as they reduce inflammation. Also, lithium carbonate is used in patients where other interventions were not helpful. For more chronic cluster headaches, nerve blocks may also be used to head off constant cluster headaches. In severe cases, surgery and radiofrequency lesioning can be used to reduce cluster headache frequency.