All about Cluster Headahes

A cluster headache is also known as: hemicrania angioparalytica, hemicrana neuralgiformis chronica, histaminic cephalalgia, Harris Horton's disease, petrosal neuralgia (of Gardner), migrainous neuralgia (of Harris), erythro-melalgia of the head, ciliary neuralgia and erythroprosopalgia of Bing.

A cluster headache is an attack of severe pain that is always on one side of head, never both. This pain can be highest around, behind or above the eye socket or in the temple area. This pain will last between fifteen minutes and three hours, occurring as low as once every 48 hours to eight times per day. Such headaches are associated with one or more ipsilateral (occurring on one side only) physical signs, some of them being fluid buildup in the eyelid, forehead and facial sweating, nasal congestion, excessive tearing of the eye, eyelid droop and more. Most sufferers of cluster headaches are restless or agitated during the episode.

Cluster headache attacks usually occur in sets (cluster periods), lasting for weeks or months. The worst headaches of the cluster period will have excruciating pain; at such times, sufferers are usually unable to lie down and typically pace the floor. In 85% to 90% of cases, there are remission periods from these sets that last months or years; in the rest of the cases, patients have chronic symptoms without remission. During a cluster period, attacks occur on a regular basis, often triggered by alcohol, nitroglycerine or a histamine.

The strongest pain centers in a cluster headache are found around the eye socket, above the eye socket or in the temple area, though pain may spread to other regions of the head. Within the same cluster period, the pain will almost always reoccur on the same side. Cluster headaches typically start at an age from 20 to 40 years, and is three to four times more common in men than women.

Chronic Cluster Headache

...cluster headaches are three to four times more common in men than women...

A chronic cluster headache is defined as cluster headache attacks occuring for more than 1 year without remission or with remissions lasting less than one month. Myofascial pain may occur in the chronic cluster headache and may complicate management of this type of headache if not identified and controlled. If one is experiencing chronic cluster headaches, an evaluation may show underlying stiffnes in the upper cervical spinal joints. Correcting posture, home stretching exercises and ultrasound therapy on trigger points in the upper trapezius and suboccipital muscles may help prevent the triggers to cluster headaches. Furthermore, for chronic headache sufferers, the possibility of over medication or medication withdrawal may continue to trigger the headaches though the underlying causes have been eliminated.

Episodic Cluster Headache

An episodic cluster headache is defined as cluster headache attacks occuring in periods lasting 1 week to 1 year separated by pain free periods lasting 1 month or longer.

Paroxysmal Hemicrania

These headaches have similar characteristics to a cluster headache, including symptoms and pain centers but are shorter lasting, more frequent and occur more commonly in females. These type of headaches respond absolutely well to the medication indomethacin. The paroxysmal hemicrana headache will occur more than five times a day more than half of the time, though a lower frequency of occurrence may occur as well.

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