Headaсhe, Cluster

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.