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Headache (cluster) : Treatment, symptoms, advice and help

About headache (cluster)

Headache is a very common ailment. There are many types of headaches, one of which is a cluster headache. This kind of headache is quite rare and characterised by episodic patterns which possess a typical model of occurrence. The cause of cluster headache is not exactly clear and thus, its treatment is not definitive and specific.

Headache (cluster): Incidence, age and sex

A cluster headache is rarely encountered in the general population. It has a high incidence in adults in the 30 to 40 years age group. Men are more frequently affected as compared with women.

Signs and symptoms of headache (cluster): Diagnosis

A cluster headache is characterized by abrupt onset of agonizing pain on one side of face which involves the eye, the forehead and head. The pain is typically piercing in nature and aggravates as time passes. The headache usually begins at midnight or during early hours of morning, especially at the time when the individual is in REM (rapid eye movement) sleep which is deep sleep wherein dreams occur. Associated features like runny nose and redness of eye may also occur. The pain may last for a few minutes to several hours and usually deteriorate with passing time. The affected individual may sometimes feel very agitated. This pain may occur same time each day for several weeks in a row and then stop abruptly to come again after a few weeks or months. Such episodes of relapse and remission are typical of cluster headache.

A history eliciting typical pattern of episodic occurrence along with intense unilateral headache is diagnostic of cluster headache. Some imaging modalities like MRI or CT scans may be needed to rule out other causes of headache.

Causes and prevention of headache (cluster)

The cause of a cluster headache is not exactly clear. It has been postulated that some neurotransmitter disturbance in the brain may lead to this phenomenon. However, some triggering factors like smoking, alcohol, glaring light, lack of sleep or mental stress may lead to headache in susceptible individuals.

Headache (cluster): Complications

A cluster headache is a functional problem and usually does not lead to any serious complications. However, it may be extremely distressing for the affected individual and cause disruption in social and personal life. The affected individual may even feel violent during an attack of headache.

Headache (cluster): Treatment

A cluster headache has no definitive and effective treatment. However, symptomatic relief may be provided by medications like sumatriptan, verapamil (calcium channel blocker) and steroids. These drugs may be given orally or as nasal sprays or even in injection form. In fact, the most effective treatment in most individuals is inhaling 100% pure oxygen via mask, especially in the early phase of headache. Susceptible individuals are recommended to avoid triggering factors like bright light and stress which induce another episode of cluster headache. The outlook of cluster headache is variable. Some individuals experience regular episodes of such headache. On the other hand, these episodes may wax or even wane in some other individuals.