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Cluster headache
| Cluster headache | |
|---|---|
 | |
| Trigeminal nerve | |
| Specialty | Neurology |
| Symptoms | Recurrent, severe headaches on one side of the head, eye watering, stuffy nose[1] |
| Usual onset | 20 to 40 years old[2] |
| Duration | 15 minutes to 3 hours[2] |
| Types | Episodic, chronic[2] |
| Causes | Unknown[2] |
| Risk factors | Tobacco smoke, family history[2] |
| Diagnostic method | Based on symptoms[2] |
| Differential diagnosis | Migraine, trigeminal neuralgia,[2] other trigeminal autonomic cephalgias[3] |
| Prevention | Verapamil, galcanezumab, oral glucocorticoids, steroid injections, civamide[4] |
| Treatment | Oxygen therapy, triptans[2][4] |
| Frequency | ~0.1% at some point in time[5] |
Cluster headache is a neurological disorder characterized by recurrent severe headaches on one side of the head, typically around the eye(s).[1] There is often accompanying eye watering, nasal congestion, or swelling around the eye on the affected side.[1] These symptoms typically last 15 minutes to 3 hours.[2] Attacks often occur in clusters which typically last for weeks or months and occasionally more than a year.[2]
The cause is unknown,[2] but is most likely related to dysfunction of the posterior hypothalamus.[6] Risk factors include a history of exposure to tobacco smoke and a family history of the condition.[2] Exposures which may trigger attacks include alcohol, nitroglycerin, and histamine.[2] They are a primary headache disorder of the trigeminal autonomic cephalalgias type.[2] Diagnosis is based on symptoms.[2]
Recommended management includes lifestyle adaptations such as avoiding potential triggers.[2] Treatments for acute attacks include oxygen or a fast-acting triptan.[2][4] Measures recommended to decrease the frequency of attacks include steroid injections, galcanezumab, civamide, verapamil, or oral glucocorticoids such as prednisone.[6][4][7] Nerve stimulation or surgery may occasionally be used if other measures are not effective.[2][6]
The condition affects about 0.1% of the general population at some point in their life and 0.05% in any given year.[5] The condition usually first occurs between 20 and 40 years of age.[2] Men are affected about four times more often than women.[5] Cluster headaches are named for the occurrence of groups of headache attacks (clusters).[1] They have also been referred to as "suicide headaches".[2]
- ^ a b c d Nesbitt, A. D.; Goadsby, P. J. (2012). "Cluster headache". BMJ. 344: e2407. doi:10.1136/bmj.e2407. PMID 22496300. S2CID 5479248.
- ^ a b c d e f g h i j k l m n o p q r s t Weaver-Agostoni, J (2013). "Cluster headache". American Family Physician. 88 (2): 122–8. PMID 23939643. Archived from the original on 30 December 2019. Retrieved 24 July 2017.
- ^ Rizzoli, P; Mullally, WJ (20 September 2017). "Headache". The American Journal of Medicine. 131 (1): 17–24. doi:10.1016/j.amjmed.2017.09.005. PMID 28939471.
- ^ a b c d Robbins, Matthew S.; Starling, Amaal J.; Pringsheim, Tamara M.; Becker, Werner J.; Schwedt, Todd J. (2016). "Treatment of Cluster Headache: The American Headache Society Evidence-Based Guidelines". Headache. 56 (7): 1093–106. doi:10.1111/head.12866. PMID 27432623.
- ^ a b c Fischera, M; Marziniak, M; Gralow, I; Evers, S (2008). "The Incidence and Prevalence of Cluster Headache: A Meta-Analysis of Population-Based Studies". Cephalalgia. 28 (6): 614–8. doi:10.1111/j.1468-2982.2008.01592.x. PMID 18422717. S2CID 2471915.
- ^ a b c Goadsby, Peter J. (2022). "Chapter 430". Harrison's Principles of Internal Medicine (21st ed.). McGraw Hill. ISBN 978-1264268504.
- ^ Gaul, C; Diener, H; Müller, OM (2011). "Cluster Headache Clinical Features and Therapeutic Options". Deutsches Ärzteblatt International. 108 (33): 543–549. doi:10.3238/arztebl.2011.0543. PMC 3167933. PMID 21912573.
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