Medically reviewed by Chris Schwerdt. Last updated on April 20, 2025
General Illness Information
Common Name:
Headache, Cluster
Medical Term: Same
Description:
Constant one-sided headache over and behind the eye, with onset occurring usually within 3-4 hours of falling asleep.
80% of these affected are males.
Pain recurs nightly for several weeks or month, followed by no symptoms for months or years.
Causes:
Unknown. Thought to be related to changes in blood flows to the brain, and to disturbances in RAM (rapid eye movement) sleep.
Prevention:
During cluster periods, avoid bright light or glare, alcohol, excessive anger, stressful activity or excitement. These will precipitate attacks.
Signs & Symptoms
- Sudden onset of headache often at night while sleeping.
- Headache reaches crescendo within 15 minutes and lasts about 2 hours.
- Pain is unilateral around the eye.
- Severe, piercing or boring pain.
- Teary eyes.
- Slow heartbeat.
- Nausea.
- Perspiration.
- Restless, active, violent (sometimes).
- Episodes of headaches occur at same time on consecutive days, with clusters of these days, separated by attack-free weeks or months.
Risk Factors
- Male, age over 30.
- Possible relationship to previous head injury or surgery.
- Prior history of migraine frequent (significant in females).
Diagnosis & Treatment
- Diagnosis is usually determined by the patient’s history of the headache patterns and symptoms.
- Therapy may involve medications and lifestyle changes.
- During cluster periods, avoid bright light or glare, alcohol, excessive anger, stressful activity or excitement. These will precipitate attacks.
- Avoid smoking, since nicotine may make cluster unresponsive to drug treatment.
General Measures:
As above.
Medications:
- Sumatriptan , or other triptans,subcutaneous (injected under the skin) or orally, may help during an acute attack. Follow all prescription instructions carefully.
- Ergotamine aerosol may be used during an attack and also as a preventive. Follow prescription instructions carefully, especially if you take more than one medication.
- Several medications are available that can help suppress headaches during a cluster period (prednisone, lithium, ergotamine, verapamil, indomethacin, and methysergide).
Activity: Avoid any activities that cause you to injure yourself during attacks
Diet:
- During clusters, avoid alcohol as it can precipitate attacks.
- Rarely, specific foods (chocolate, eggs, dairy products) trigger attacks.
Possible Complications :
- Self-injury during attack.
- Side effects of drugs.
Prognosis
No cure is available, but treatment can help control the pain and shorten the cluster period.
Prolonged remissions.
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