Symptoms of cluster headaches involve excruciating pain earning nicknames such as “suicide headache” or “alarm clock headache” owing to the fact that cluster headaches can awaken a person from sleep. The headache pain occurs in cyclic patterns of one to three headaches per day per cluster period (usually lasting two weeks to three months). The headache then disappear completely as the person goes into remission. Remission may last for months or even years.
Cluster Headaches Symptoms And Causes
Cluster headaches are rare and not life-threatening but are very intense. The headaches strike quickly, often without warning. Symptoms of cluster headaches include:
Excruciating, burning or knife-like pain felt behind or around one eye that spreads over that half of the face or head and may radiate into the neck and shoulder
Congestion or runny nose
Swelling around the eye on the affected side of the face
Difficulty closing the affected eyelid (Ptosis) or a drooping eyelid
Excessive tearing and redness of the eye on the affected side
Reduced pupil size
Restlessness (pacing or rocking behavior)
Cluster headaches are usually brief, often lasting only 15 minutes and rarely lasting more than a few hours. However, they are excruciating and intense. The pain will typically end as quickly as it began. Following an attack the person will be completely free of pain, but exhausted.
Some will report migraine-like symptoms including nausea, sensitivity to light and sound or an aura, however, unlike a migraine, these symptoms may be experienced on only one side.
As the name suggests, cluster headaches usually occur for a few weeks to months then disappear. A sufferer may experience symptoms in a cyclic pattern with headaches appearing at approximately the same time each year. Symptoms commonly arise in the spring and fall.
Cluster headaches are not common. Ninety percent of cluster headache sufferers are male, most between the ages of 20-30 years old (although headaches can develop at any age). Having a family history of this type of headache will make you more susceptible to having them yourself.
The definitive cause of cluster headaches is not well understood, but may involve abnormalities of the hypothalamus. The hypothalamus is the part of the brain that controls your “internal biological clock” which regulates sleep and wake cycles.
It is thought that the hypothalamus plays a role in activating the trigeminal nerve. The trigeminal nerve is the main nerve of the face and is responsible for sensations such as heat and pain. When activated, the nerve causes the eye pain experienced with cluster headaches. It also stimulates another group of nerves responsible for the tearing, redness, nasal congestion and runny nose associated with these headaches.
Cluster headaches tend to be influenced by seasonal changes, with the spring and fall being the most common times for headaches to occur, this may be tied to the abnormalities of the hypothalamus. During a cluster period, headaches may be triggered by alcohol consumption or smoking. Other possible triggers include histamine injection and nitroglycerin ingestion.
Cluster Headaches Diagnosis And Treatment
A person who just started experiencing this type of headache should see a doctor to rule out other disorders. The headache pain, though severe, is usually not the result of an underlying disease, however, other conditions such as a brain tumor or aneurysm could mimic the symptoms of cluster headaches.
A proper diagnosis will be mainly based on the characteristics of the headaches such as the type of pain and the pattern of attacks. An evaluation by a medical physician may include a physical examination, blood tests, and imagining tests such as CT or MRI scans.
Alternate diagnosis that will need to be ruled out include: Migraines (especially facial migraines), Raeders Paratrigeminal Syndrome, Trigeminal Neuralgia, internal carotid aneurysm, or headache due to TIA (Transient Ischemic Attack) or infarction of lateral medulla.
There is no known cure for cluster headaches. Treatment will be geared toward decreasing the severity of the pain and shortening the duration of the attacks and the length of the cluster period.
Over-the-counter pain medications such as aspirin and ibuprofen are often ineffective in the treatment of cluster headaches due to the fact that the headaches come on suddenly and often subside within a short time, leaving no time for the drug to have an effect. However, there are a number of fast-acting treatments that can provide some pain relief. These fast-acting treatments include:
100 percent Oxygen inhaled through a mask
The injectable form of sumatriptan (Imitrex)
Octreotide (Sandostatin, Octreotide Acetate) injections
Local anesthetics such as lidocaine (Xylocaine) used intranasally
Dihydroergotamine (D.H.E. 45, Migranal) administered intraveneously
Other medications may be prescribed as preventive therapy. The goal of these medications is to suppress an attack as it starts. Your doctor may prescribe:
Calcium channel blocker agent, verapamil (Calan, Verelan)
Coticosteroids such as prednisone
Surgery to block the trigeminal nerve may be an option for those who do not tolerate the medications or who have not been helped with standard treatment.
Take an active role in your health by learning all you can about Cluster Headaches
You can read more about this condition and use a free tool that walks you through your symptoms and leads you to an online diagnosis. Prepare yourself before your doctor’s visit and figure out what your symptoms mean using this Medical Symptom Diagnosis Tool.
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