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Cluster Headaches

What is a cluster headache?

Cluster headaches are rare when compared to other types of headaches. The pain they produce is severe and tends to recur in the same way each time. They occur in groups, or clusters, and each attack lasts about 1 to 3 hours on average. The frequency of occurrence may range from every other day to multiple times a day. Cluster periods are followed by remissions that may last months or years. 

Males are affected by cluster headaches more than females and they typically start around age 30.

What causes cluster headaches?

Researchers do not know exactly what causes cluster headaches. They seem to be related to the sudden release of histamine or serotonin in the body.

The following may trigger cluster headaches:

  • Alcohol use or smoking cigarettes
  • Change to a high altitude
  • Bright light
  • Exercise or exertion
  • Heat, either weather or a bath
  • Foods that contain nitrates, such as bacon or lunch meat
  • Cocaine use

What are the symptoms of cluster headaches?

These are common symptoms of a cluster headache:

  • Sudden onset of pain, generally around or behind the eye
  • Pain builds to a peak in about 10 to 15 minutes
  • Restlessness or agitation
  • Red or watering eyes
  • Nasal congestion
  • Sweating on the forehead
  • Eyelid drooping or swelling

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The symptoms of a cluster headache may look like other conditions or medical problems. Always see your doctor for a diagnosis.

How are cluster headaches diagnosed?

Cluster headaches are diagnosed based on your history of a pattern of recurrent bouts of near-daily headache attacks lasting for days, weeks, or months.

How are cluster headaches treated?

A two-pronged approach is necessary for treatment of cluster headaches: aborting an attack and preventing future attacks.

To stop or at least subdue an attack in progress, you may be given high-dose oxygen therapy through a face mask for 15 to 20 minutes. Your doctor may also prescribe a nasal spray called sumatriptan to relieve the severe pain of a cluster headache. Sumatriptan is a selective serotonin receptor agonist. This medicine causes blood vessels in the brain to constrict, thereby relieving pain.

The second part of cluster headache treatment is to prevent recurrent attacks by using daily medicine. Several medicines are used to prevent cluster headache attacks:

  • Verapamil. A medicine that relaxes blood vessels.
  • Prednisone. A steroid that reduces inflammation and swelling.
  • Lithium carbonate. A medicine that restores the balance of certain brain chemicals.

What are the complications of cluster headaches?

A true cluster headache is not life threatening and does not cause permanent brain damage. But, they tend to be chronic, recurrent, and can interfere with your lifestyle or work.

Can cluster headaches be prevented?

To prevent a cluster headache, it’s important to identify what triggers your headaches.  Try avoiding smoking and alcohol use. Your doctor may be able to prescribe a medicine regimen that will help prevent cluster headaches.

When should I call my healthcare provider?

There are some danger signs that may occur with cluster headaches that warrant immediate medical care. These include:

  • Changes in alertness
  • Loss of movement or sensation
  • Drowsiness
  • Nausea or vomiting
  • Seizure activity
  • Changes in vision

Key points about cluster headaches

  • Cluster headaches occur in groups, or clusters, and each attack lasts about 1 to 3 hours on average.
  • The frequency of occurrence may range from every other day to multiple times a day.
  • Cluster periods are followed by remissions that may last months or years.
  • Relative to other types of primary headaches, cluster headaches are rare.
  • The pain they produce is severe and they tend to recur in the same way each time
  • Identifying headache triggers may help prevent their occurrence.
  • A true cluster headache is not life threatening and does not cause permanent brain damage. But, they tend to be chronic, recurrent, and can interfere with your lifestyle or work.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
Online Medical Reviewer: Dozier, Tennille, RN, BSN, RDMS
Online Medical Reviewer: Shelat, Amit, MD
Date Last Reviewed: 8/1/2016
© 2000-2016 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.