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Cluster Headache


What is a cluster headache?

A cluster headache is a very painful headache that starts quickly, peaks within 15 minutes, and stops suddenly. The headache usually lasts 30 to 60 minutes but can last up to 3 hours. A cluster period usually lasts for 2 to 12 weeks but can last longer than a year. Weeks or months may pass before a new cluster period begins. A cluster headache can be triggered by alcohol, medicine, stress, bright light, or heat.

What increases my risk for a cluster headache?

The cause is not known. You are more likely to have cluster headaches if you are male. They often begin when the person is between the ages of 20 and 40 years. If you smoke or have a family history of cluster headaches, you are more likely to get them.

What are the signs and symptoms of a cluster headache?

Cluster headaches follow patterns and often occur at the same time of the day or year. You may have cluster headaches once every other day, or up to 8 each day. You may also have any of the following:

Cluster headaches may involve pain around one eye, along with drooping of the lid, tearing and congestion on the same side as the pain
  • Severe pain on one side of your head that stabs or burns
  • Swollen or watery eye, or droopy eyelid
  • A runny or stuffy nose
  • Red or sweaty face
  • Restlessness
  • Sensitive to noise or light
  • Exhaustion after the headache stops

How is a cluster headache diagnosed?

Your healthcare provider will ask you to describe your symptoms. Tell him how often your headaches occur and how long they last. He will ask about your medical history. He will look at your face and eyes. He will ask for a list of your medications. Tell him if you smoke cigarettes or drink alcohol. You may need any of the following tests:

  • A neurological exam is a series of tests to check for problems with your brain and nervous system. Your healthcare provider will shine a light in your eyes to find out how they react to light. He may ask questions to check your memory. He may check your hand grasp and balance.
  • CT scan or MRI pictures may be taken of your brain and the blood vessels and structures in your head. You may be given contrast liquid to help images show up better on the monitor. Tell healthcare providers if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with any metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in your body.

How is a cluster headache treated?

There is no cure, but treatment may help your signs and symptoms. Your healthcare provider may have you try several medicines to find out what works best for you. You may need a blend of medicines for pain and for prevention. The following may be used to treat pain during a cluster headache:

  • Extra oxygen may give you pain relief during a cluster headache. You will breathe through a plastic mask that is attached to an oxygen tank for about 15 minutes.
  • Migraine medicine may be given to relieve your pain quickly.
  • Steroids help reduce pain and swelling. They may also be used to prevent cluster headaches.
  • Numbing medicine may be given to numb your pain if other treatments do not work.

What can I do to prevent a cluster headache?

One goal is to prevent headaches before they happen. Another goal is to shorten a cluster period. Headaches may happen less often and be less severe with certain medicines. Seizure medicine or mood stabilizers may be given to prevent cluster headaches. You may need to take one medicine at the start of a cluster period. You may take a different medicine for as long as your cluster period lasts or is expected to last.

How can I manage my cluster headaches?

  • Do not smoke. Cluster headaches are more common among smokers. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.
  • Do not drink alcohol during a cluster period. Alcohol triggers more headaches during cluster periods.
  • Do not travel between altitudes. Altitude changes can trigger headaches. Do not fly on an airplane or travel between places with high and low altitudes.
  • Set a regular sleep schedule. Go to sleep and wake up at the same times each day. Changes in sleep patterns may trigger cluster headaches.
  • Manage stress. Stress, long hours at work, and emotional challenges can trigger cluster headaches. Find out what works for you to lower stress.
  • Keep a headache journal. Write down when your headaches start and stop, and exactly what you were doing when they began. Record what you ate or drank and how much you slept in the 24 hours before the headache. Keep track of the things you did to treat your symptoms. Write down if they did or did not help. Do this to learn what triggers your headaches and how to make them go away.
  • Work with your healthcare provider to manage your pain. Both pain relievers and medicines used to treat other health conditions can trigger cluster headaches. Go over all your medicines with your healthcare provider. Work with him to manage your headache pain and other conditions.

When should I seek immediate care?

  • You feel more tired or sleepy than usual.
  • You notice changes in your vision.
  • Your stomach is upset or you are vomiting.
  • You have a seizure.

When should I contact my healthcare provider?

  • You cannot get enough sleep because of your headaches.
  • Your headaches happen each time you are active.
  • Treatment does not help your symptoms.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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