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Cluster HeadachesCefalea en Racimos

Cluster Headaches

What is a cluster headache?

Cluster headaches are rare when compared to other types of headaches. The pain they produce is severe and tends to recur in the same way each time.

Cluster headaches occur in groups, or clusters, and each attack last about 1 to 3 hours on average. The frequency of occurrence may range from every other day to multiple times a day. Cluster periods are followed by remissions that may last months or years. 

Males are affected by cluster headaches more than females and then typically begin around age 30.

What causes cluster headaches?

Researchers do not know exactly what causes cluster headaches. They seem to be related to the sudden release of histamine or serotonin in the body.

The following may trigger cluster headaches:

  • Alcohol use or smoking cigarettes
  • Change to a high altitude
  • Bright light
  • Exercise or exertion
  • Heat, either weather or a bath
  • Foods that contain nitrates, such as bacon or lunch meat
  • Cocaine use

What are the symptoms of cluster headaches?

While symptoms may differ from person to person, the following are common symptoms of a cluster headache:

  • Sudden onset of pain, generally around or behind the eye
  • Pain builds to a peak in about 10 to 15 minutes
  • Restlessness or agitation
  • Red or watering eyes
  • Nasal congestion
  • Sweating on the forehead
  • Eyelid drooping or swelling

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The symptoms of a cluster headache may resemble other conditions or medical problems. Always see your doctor for a diagnosis.

How are cluster headaches diagnosed?

Cluster headaches are diagnosed based on your history of a pattern of recurrent bouts of near-daily headache attacks lasting for days, weeks, or months.

How are cluster headaches treated?

A two-pronged approach is necessary for treatment of cluster headaches: aborting an attack and preventing future attacks.

To stop at least subdue an attack in progress, you may take oxygen through a face mask. Your doctor may also prescribe a nasal spray called sumatriptan (Imitrex) to relieve the severe pain of a cluster headache. Sumatriptan is a selective serotonin receptor agonist -- a medication that causes blood vessels in the brain to constrict, thereby relieving pain.

The second part of cluster headache treatment is to prevent recurrent attacks by using daily medication. Several medications are used to prevent cluster headache attacks:

  • Verapamil. A medication that relaxes blood vessels.
  • Prednisone. A steroid medication that reduces inflammation and swelling.
  • Ergotamine. A medication that works together with caffeine to prevent blood vessels in the head from expanding.

What are the complications of cluster headaches?

A true cluster headache is not life threatening and does not cause permanent brain damage. But, they tend to be chronic, recurrent, and can interfere with your lifestyle or work.

Can cluster headaches be prevented?

To prevent a cluster headache, it’s important to identify what triggers your headaches.  Try avoiding smoking and alcohol use. Your doctor may be able to prescribe a medication regimen that will help prevent cluster headaches.

Living with cluster headaches

Cluster headaches may go away on their own. If not, you will need a treatment regimen to relieve or prevent cluster headaches.

When should I call my health care provider?

There are some danger signs that may occur with cluster headaches that warrant immediate medical care. These include:

  • Changes in alertness
  • Loss of movement or sensation
  • Drowsiness
  • Nausea or vomiting
  • Seizure activity
  • Changes in vision

Key points

  • Cluster headaches occur in groups, or clusters, and each attack last about 1 to 3 hours on average.
  • The frequency of occurrence may range from every other day to multiple times a day.
  • Cluster periods are followed by remissions that may last months or years.
  • Relative to other types of primary headache, cluster headaches are rare.
  • The pain they produce is severe and they tend to recur in the same way each time
  • Identifying headache triggers may help prevent their occurrence.
  • A true cluster headache is not life threatening and does not cause permanent brain damage. But, they tend to be chronic, recurrent, and can interfere with your lifestyle or work.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.