Cluster headaches

What is a cluster headache?

A cluster headache is a very serious, but fortunately rare, type of headache. They present with a shooting pain that affects only one side of the head, often in the area near the eye, and affects approximately one person in every 500-100. Generally, cluster headaches appear for the first time in people in their 30s and 40s, although it can occur at all ages. They are most common in males. Some people experience pain-free periods ( episodic cluster headaches), whilst others suffer chronically without these pain-free periods.


Cluster headache is not considered a medical emergency or life-threatening, however, they can seriously affect quality of life in those who suffer from them. For this reason, it is necessary to contact a specialist able to direct the patient towards the most suitable treatment and relief.

Symptoms of a cluster headache:

A cluster headache generally manifests itself with repeated episodes that can last weeks (usually from 4 to 12). These episodes are called "active periods" and alternate with phases without any type of headache (remission period) that can last for months or even years.

Cluster headache attacks occur without warning and with strong intensity. The sensation often described by sufferers is of sharp, stabbing pain, burning around the eye and the temple.

In addition to pain, this type of headache can present the following symptoms:

  • Redness and tearing of the eye, with swelling in just one eyelid
  • Pupil narrowing in one eye
  • Facial sweating
  • A blocked or runny nostril

The attacks, which last from 15 minutes to three hours, can be repeated within the same day up to a maximum of eight times.

How are cluster headaches diagnosed?

When a headache occurs which has the characteristics of a cluster headache, it is necessary to consult with your doctor who will direct the patient towards a specialist. Generally the diagnosis of cluster headache occurs by assessing the patient’s medical history and, if necessary, the use of tests such as a CT and brain MRI. If your doctor feels satisfied that cluster headaches are suspected, then you will be referred to either a neurologist or a headache specialist.

What are the causes of cluster headaches?

The causes of this type of headache are not yet clear, but according to studies there is the possibility that the triggering factor lies in thehypothalamus. Furthermore, genetic predisposition is believed to play an important role in the onset of this disease, given that many times it affects multiple members of the same family.

Can cluster headaches be prevented?

In some cases, the specialist can prescribe a treatment (prophylaxis) to the patient to help prevent attacks of cluster headaches that must be started when the attack occurs and must be followed until its end. Furthermore, the external stimulation of the vagus nerve also offers good results. In any case, the therapy may vary from patient to patient and it may be necessary to try different types of treatments before finding the most suitable one.

Treatments for cluster headaches

Cluster headaches can be treated with drug therapy, although analgesic usually takes a long time to take effect. In addition to this, there are three other possible treatments, which can relieve pain if taken soon after a cluster headache starts, kicking in within 15-30 minutes:

  • Sumatriptan injections, to be performed up to twice a day
  • Nasal sprays, for patients who do not want to have injections
  • Inhalation of pure oxygen through a facial mask

Which type of specialist treats cluster headaches?

Cluster headaches are usually treated by either a neurologist or a headache specialist.

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