FAQs on Cluster Headaches

Cluster headache is a type of headache that mainly affects men. It is rare, occurring in less than 1% of the population. In an analysis of several population-based studies, the lifetime prevalence of cluster headache for all ages was found to be 1 per 1,000 people (0.1%). These headaches are described as severe and excruciating, and they tend to occur in clusters, hence the name.

What are the symptoms of cluster headache?

The pain associated with cluster headache is unilateral (occurring on one side), but the side can differ occasionally. The pain is typically centered over one eye, one area of the forehead, or one temple region, but it can spread out to a larger area.

The episodes of pain tend to occur about the same time each day, often starting at night a couple hours after the person has went to sleep. During a bad cluster, the patient can experience head pain up to 8 times per day, or with a mild cluster, the headache could occur ever couple of days. Common associated symptoms that occur along with the pain are a blocked or runny nose, redness of one eye, and a drooping eyelid – all on the same side as the pain.

What is the duration of a “cluster?”

In approximately 80% of people, the clusters of head pain last between 4 to 12 weeks, occurring once a year at the same time. The most common seasons for cluster headaches are Spring and Fall. The other 20% of people with cluster headaches do not have pain-free intervals, which is known as chronic cluster headache.

Who can get cluster headache?

Cluster headache occurs at any age, but most often affects individuals 20 years old and older who are heavy smokers. As the patient ages, the pain-free episodes tend to get longer.

Cluster headache runs in families, and around 1 in 20 people with this condition have a family member who suffers these headaches. Unlike other types of headaches, cluster headache is more common in men than women, with the ratio of occurrence at 6:1

What triggers cluster headache?

Most headaches are brought on by a substance or circumstance that is referred to as a “trigger.” With cluster headache, one of the well-known triggers is alcohol, which brings about the pain within one hour of drinking. In addition, many patients report that certain substances with strong odors trigger the head pain, such as perfume, bleach, and paint fumes. Another common trigger is exercise or physical exertion.

How is cluster headache diagnosed?

There is no one test used to diagnose cluster headache. Rather, the diagnosis is made based on the patient’s report of the symptoms and situation, as well as ruling out other serious problems.

The doctor will take a detailed medical history and conduct a comprehensive physical examination. In addition, certain diagnostic tests will be used, such as erythrocyte sedimentation rate (ESR) and complete blood count (CBC) blood tests, sinus x-rays, and possible a MRI or CT of the head.

What are the treatment options for cluster headache?

There are several treatment options available for those who suffer from cluster headache. These include:

  • Occipital nerve block (ONB) – The ONB involves an injection of an anesthetic agent into the posterior region of the head near the occipital nerve. In one recent clinical study where ONB was used for face pain, 100% of patients with occipital neuralgia reported pain relief, along with 75% of those with trigeminal neuralgia.
  • Sphenopalatine ganglion block (SPGB) – With this procedure, the doctor numbs the inside of the nostril or cheek with an anesthetic gel. Then, a small needle is inserted near the sphenopalatine ganglion, which is a mass of nerves at the base of the brain near the back of the throat. The doctor injects the nerve region with a long-acting anesthetic. Recent research shows that two-thirds of patients report improved symptoms within 7 days of the SPG, with 50% reporting pain relief within 30 days of the block.
  • Oxygen – For a severe, acute episode of pain related to cluster headache, inhalation of 100% oxygen through a mask has been shown to provide quick relief.
  • Injectable medications – Sumatriptan (Imitrex) is an injectable drug used to abort the cluster headache. Octreotide (Sandostatin) is an injectable hormone that relieves the pain of cluster headache.
  • Preventive medications – To prevent cluster headache from occurring, several medications are prescribed. These include calcium channel blockers, corticosteroids, lithium carbonate, melatonin, and ergotamine.