Cluster headache - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Cluster headache is the most common trigeminal autonomic cephalalgia. This primary headache disorder is characterized by attacks of severe unilateral pain localized to the orbital, periorbital, and/or temporal areas that last from 15 to 180 minutes. It occurs from once every other day to 8 times per day.
In episodic cluster headache, attacks occur over a period of time (the cluster period), with periods of remission of at least 3 months between cluster periods. The cluster period usually lasts for several weeks, and often occurs at the same time during the year. Some patients can develop chronic cluster headache, where they experience attacks without a remission period or with remission periods lasting less than 3 months, for at least 1 year.
Attacks are accompanied by cranial autonomic symptoms or signs ipsilateral to the pain. Most patients are restless or agitated during attacks.
Pathophysiology is thought to result from hypothalamic activation with secondary trigeminal and autonomic activation. Triggers for cluster attacks include alcohol, strong smells, sleep, circadian disruption, and weather changes.
Diagnosis is based on International Headache Society International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria.

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Citations

Key Articles

Schindler EAD, Burish MJ. Recent advances in the diagnosis and management of cluster headache. BMJ. 2022 Mar 16;376:e059577.[Abstract]
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211.[Abstract][Full Text]
American College of Radiology. ACR appropriateness criteria: headache. 2022 [internet publication].[Full Text]
Robbins MS, Starling AJ, Pringsheim TM, et al. Treatment of cluster headache: the American Headache Society evidence-based guidelines. Headache. 2016 Jul;56(7):1093-106.[Abstract][Full Text]
Law S, Derry S, Moore RA. Triptans for acute cluster headache. Cochrane Database Syst Rev. 2013 Jul 17;(7):CD008042.[Abstract][Full Text]
May A, Evers S, Goadsby PJ, et al. European Academy of Neurology guidelines on the treatment of cluster headache. Eur J Neurol. 2023 Oct;30(10):2955-79.[Abstract][Full Text]

Referenced Articles

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