Causes
Cluster headaches, like migraines, are likely due to an interaction of abnormalities in the blood vessels and nerves that affect regions in the face.
Abnormalities in the Hypothalamus
Evidence now strongly suggests that abnormalities in the hypothalamus, a complex structure located deep in the brain, may play a major role in cluster headaches. Advanced imaging techniques have revealed that a specific area in the hypothalamus is asymmetrical in these patients and is activated during a cluster headache attack.
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The hypothalamus is involved in the regulation of many important chemicals and nerve pathways, including the following:
- Nerve clusters that regulate the body's biologic rhythms (its circadian rhythms).
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Click the icon to see an image of the hypothalamus. |
- Serotonin and norepinephrine. These are neurotransmitters (chemical messengers in the brain) that are involved with well being and appetite.
- Cortisol (stress hormones).
- Melatonin (a hormone related to the body's response to light and dark).
- Beta-endorphins (substances that modulate pain).
Circadian Abnormalities. Cluster attacks often occur during specific sleep stages. They also often follow the seasonal increase in warmth and light, beginning in summer and ending in the fall. Researchers have therefore focused attention on circadian rhythms, and in particular small clusters of nerves in the hypothalamus that act like biologic clocks.
The most important nervous cluster is the suprachiasmatic nuclei (SCN), which appears to help coordinate the body's activities (sleep/wake) with the environment (dark/light). Some studies support the idea that some failure in this biologic pacemaker may impair the pain control system and cause these terrible attacks.
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