Cluster Headaches

Some of the most painful and debilitating headaches recorded are cluster headaches. They usually come without any sort of warning and prevent any type of activity until it abates. These headaches recur periodically or in clusters, cycling through periods of pain and periods where the pain disappears. Cluster periods can last from weeks or months with long periods of total remission.

Classification

Cluster headaches usually occur in a pattern that is different for everybody. You may get them every spring, but someone else may have them year round on a regular basis. Like other headaches, there are two main classifications:

  • Episodic Headaches – Clusters that present themselves from one week to a year with long periods of remission
  • Chronic Headaches – Clusters that occur for longer than a year, or with very short remission periods

Symptoms

The pain of a cluster headache is usually very excruciating, causing debilitation. Although not life threatening, many people nickname these headaches "suicide headaches" because of the intense pain.

When going through a cluster headache, you may experience the following:

    • Headaches occur every day and possibly many times per day
    • Attacks lasting from 15 minutes to up to three hours
    • Recurring attacks at approximately the same time each day
    • Attacks usually occur at night

The pain typically ends as abruptly as it begins. Fighting through one of these headaches often causes exhaustion in the sufferer.

Other symptoms that differentiate cluster headaches from other types of headaches include:

  • Drooping eyelids
  • Runny nose
  • Watery eyes
  • Redness of the eyes

These symptoms are responses of the autonomic nervous system caused by the headache.

Causes

Although the exact causes are unknown, the cyclical nature of the episodes seems to indicate that they are related to the body's biological clock or circadian rhythms. The hypothalamus, one of the main glands of the endocrine gland system, may be involved in these types of headaches.

Studies have linked changes in the following chemical levels of the brain to cluster headaches:

  • Hormones
  • Neurotransmitters

Triggers

Unlike migraine or tension headaches, there are typically no triggers that bring about or start cluster periods. Therefore, there are really no triggers that you can avoid. The cyclical nature of the clusters can prepare you for the next one. If you suffer from clusters every spring, you can take some steps to get ready for their next onset.

Treatment

Medical treatments for cluster headaches include:

  • Oxygen
  • Triptan injections (Imitrex)
  • Nasal triptan (Zomig)
  • Sphenopalatine blocks can sometimes abort the attacks

Surgery is another, more radical and dangerous medical option sometimes used to treat cluster headaches.

  • Conventional surgery – The doctor will cut or block a portion of the trigeminal nerve.
  • Glycerol injection – this is now the preferred surgical treatment method where an injection of glycerol to the face can bring almost immediate relief.

Surgery is not a frontline approach but may be a treatment for severe and resistant problems. 

If this is the first time you have ever experienced cluster headaches, you should see a doctor to rule out that there is not something else causing the pain. You will likely begin a regimen of short-term medications to abort the pain, followed by a long-term maintenance plan to prevent or minimize future headaches.

If you suffer from cluster headaches, let our iHATEheadaches doctors help you from your pain, contact our doctors today for a chronic headache consultation.

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