Headaches: Cluster - Highlights

Highlights

What Are Cluster Headaches?

Cluster headaches are among the most painful types of headaches. They are marked by excruciating stabbing and penetrating pain, which is usually centered around the eye. Cluster headache attacks occur very suddenly and without warning, with the pain peaking within 15 minutes. During an attack, the patient is very restless and agitated while trying to cope with the severe pain.

Symptoms of Cluster Headache Attacks

In addition to pain, symptoms of cluster headaches may include:

• Swollen or droopy eyelid
• Watery, tearing eye
• Stuffy or runny nose
• Contracted eye pupil
• Forehead and facial sweating
• Intolerance to light and sound

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Who Gets Cluster Headaches?

• Cluster headaches are rare, affecting less than 1% of the population.
• Men, usually in their 40s, are much more likely to suffer from cluster headaches than women.
• Many people who have cluster headaches have a personal or family history of migraine headaches.

Treatment

Treatment of cluster headaches focuses on relieving pain when attacks occur, and on preventive strategies to reduce attack duration and frequency. Oxygen therapy and sumatriptan (Imitrex) injection are the most effective treatments for acute attacks. Verapamil (Calan), a high blood pressure drug, is typically the first choice of medication used for long-term prevention.

Behavioral treatments can be a helpful supplement to drug therapy. These treatments include relaxation therapy, biofeedback, cognitive-behavioral therapy, and stress management. Patients should also identify and avoid any triggers, such as alcohol use and cigarette smoking, which may provoke cluster headache attacks.

Review Date: 09/29/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).