Cluster headaches occur cyclically or periodically at specified intervals, after which condition they got their name – cluster. The cluster headache is one of the most pain causing types of headaches.
It is sometimes called ‘alarm-clock-headache’, because it may occur in the middle of the night in a strong and intense form of pain in or around the eye area.
The headache attacks can last for weeks or months, often followed by peaceful periods when the headache completely ceases. During the remission, no headaches occur in a period of a month, and in some cases even a year.
Fortunately, cluster headaches are rare condition that does not endanger human life. A proper treatment can help to limit and reduce the intensity of headaches.
Symptoms
The cluster headache usually occurs abruptly, often without any warning. Typical signs and symptoms include:
– severe pain, generally located in and around the eye, but can be extended to other parts of the face, head, neck and shoulders
– one sided pain
– restlessness (fatigue)
– increased lacrimation
– redness in the eye on the affected side
– stuffy nose, or increased nasal secretion on the affected side
– sweaty, pale skin on the face
– Swelling around the eye on the affected side of the face
– Reduced size of the eye pupil
– Lowered eyelid
The pain caused by the cluster headache is often described as sharp, penetrating or burning pain. People with this condition say that pain causes a sensation as the eye will come out of its place. Compared with people who suffer from migraines, persons with cluster headaches often avoid the supine position during the headache attack, because that position increases the pain.
Characteristics of the cluster period
The cluster period generally lasts from 6 to 12 weeks. These periods may occur seasonally, such as every spring or fall. During this period:
– headaches typically occur every day, sometimes several times a day
– the single attack can last from 15 minutes to 2 hours
– the attack usually happens at the same time of the day or night
– In most cases, the attacks of headaches occur 2 hours after a person lie down to sleep
Causes
The exact cause of cluster headaches is unknown, but abnormalities in the hypothalamus, appears to have played an important role in their appearance. That cluster headaches occur at certain times of the day and at a certain time of the year, indicates the fact that the biological clock is highly involved. In humans, the biological clock is located in the hypothalamus, located centrally in the brain.
Compared to migraine and the tension headaches, cluster headaches are generally not associated with triggers such as food, hormonal changes or stress. However, as the cluster period appears, consumption of any alcohol can easily stimulate increased appearance of these headaches.
Because of this, many who suffer from cluster headaches during this period, are avoiding consumption of alcohol. The other triggers that can be mentioned are drugs such as nitroglycerin, mainly used in treatment of heart disease. (heart attack prevention)
Risk factors
Risk factors for cluster headaches include:
– Gender – Men more often suffer from these type of headaches.
– Age – Most people with cluster headaches for the first time, start to develop this disorder in their late 20’s, although this may occur at any age.
– Smokers – Most people who have cluster headaches are smokers. (Quit Smoking Easily and Naturally)
– Alcohol – Alcohol can cause an attack of cluster headaches.
– Family History – If a parent or close relative ever had cluster headaches, then the risk of occurrence of such headaches is significantly higher.
Diagnosis
Cluster headaches have a characteristic type of pain and time of occurrence of the attacks. Diagnosis depends on the description of the attacks, including pain, location and severity of headaches and associated symptoms. To properly diagnose, it is necessary to make the following tests:
– Neurological examination
– Visualization tests (computed tomography, (MRI) magnetic resonance imaging)
Treatment
Particularly, there is no precise cure for the cluster headaches. The goal of treatment is to reduce the severity of the pain, to reduce the cluster periods and to prevent the recurrence of the seizures.
Acute treatment
– Short-term inhalation of 100% oxygen through a mask contributes to a significant relief for most patients.
– Triptans – Injection form of sumatriptan, which is often used to treat migraines, is also an effective acute treatment for cluster headaches.
– Octreotide – This injection form is a synthetic version of the brain hormone called somatostatin, and it is an effective treatment for cluster headaches. This treatment is suitable for people who also suffer from high blood pressure or coronary heart disease.
– Local anesthetic – The intranasally application of a local anesthetic such as lidocaine, offers temporary relief of pain in these patients.
– Dihydroergotamine – This medication is available in intravenous, injection and inhalation form. The Dihydroergotamine is an effective analgesic for some people with cluster headaches.
Preventive treatment
– Calcium channel blockers
– Corticosteroids
– Lithium carbonate
– Nerve Blocks
– Ergotamine
– Melatonin
