Cluster headaches happen in cyclical patterns or cluster periods which is categorised by pounding pain on one side of the head. Usually, cluster headache can make a person awaken in the middle of the night with intense pain in or around one eye on one side of the head. An episode of recurrent attacks is known as cluster periods that can last from weeks to months, which is followed by remission periods when the headaches settle. While during the remission phase, no headaches occur for months and at times even years. It is quite common among adolescence and the middle age but can also occur at any age.
This type of headache is rare and not life-threatening. Proper treatment can make cluster headache attacks shorter and lessen the severity.
Generally, a cluster headache strikes rapidly without any warning sign, but a person may first experience migraine like nausea and aura. Other signs and symptoms associated with cluster headache include:
Throbbing pain in, behind, or around one eye, but it may also radiate to other regions of the face, head, and neck
Redness of eye
Runny or stuffy nose
Swelling in the forehead or facial side affected
Drooping eyelid on the affected side
People affected with cluster headaches are likely to pace and rock back and forth, unlike those with migraine. Sensitivity to light and sound can also occur with a cluster headache but on one side.
What Is A Cluster Period?
A cluster period usually lasts for several weeks to months. The starting date and duration of each cluster period remain constant from period to period. For instance, cluster periods can develop seasonally, like every spring or every fall.
Most individuals experience episodic cluster headaches that occur for one week to a year followed by a pain-free remission period that can last for 12 months before another cluster headache happens. At times chronic cluster periods may continue for more than a year or pain-free periods might last less than a month.
During a cluster period a person may have:
Headaches every other day or sometimes several times in a day.
A single episode can hold up from 15 minutes to 3 hours
Each attack often develops at the same time each day
Most attacks develop at night, 1 to 2 hours after a person goes to bed
The pain usually ends as suddenly as it begins, with quickly decreasing intensity. After attacks, most individuals are pain-free but extremely fatigued.
The exact cause of cluster headaches is still not known, but patterns suggest that any abnormalities in the hypothalamus play a major role. Distinct from migraine and tension headache, cluster headache is not linked to triggers such as foods, hormonal changes, or stress.
But once a cluster period starts, drinking alcohol may rapidly trigger a splitting headache, thus one should avoid drinking alcohol during a cluster period.
Other potential triggers include certain medications used to treat heart disease.
Men are more prone to have cluster headaches than women.
Cluster headaches develops in most people between ages 20 and 50, but this health condition can occur at any age.
Most people who smoke get cluster headaches.
A family history of cluster headaches may increase a person’s risk.
The doctor may diagnose cluster headache based on the characteristics of the attacks such as pain, location and severity and associated symptoms. Also, how frequent headaches occur and how long they last are vital factors.
A complete neurological evaluation may help the doctor identify the physical signs of a neurological disorder. Further, the doctors may also use certain procedures to assess brain function, including testing senses, reflexes, and nerves.
If a person has unusual headaches or abnormal neurological examination, then the doctor may suggest certain imaging tests such as brain MRI and CT scan to rule out the causes of head pain such as a tumour or an aneurysm.
There is no complete cure for cluster headaches. The main goal of treatment is to reduce the severity of pain, shorten the headache period and prevent attacks. Since the pain of a cluster headache occur suddenly and may subside within a short time, cluster headache can be hard to evaluate and treat, as it needs fast-acting medications.
Pain medication relieves headache pain once it has begun. Some of the treatments include:
Oxygen: Breathing pure oxygen during an episode of headache can help ease symptoms
Prescription nasal spray medications and injections are also recommended.
Capsaicin topical creams can be applied to the painful region to alleviate pain