Cluster headaches is type of headache belongs to the Primary headache classification and this is one of the most severe forms of headaches. This type of headache is also less common than tension headaches or migraine. [1] Cluster headaches are beginning more dramatically and they are staying unique in their course over time. Cluster headaches are excruciating attacks of pain in one side of our heads and often they are felt around our eye. This is a rare type of headaches. Every single person can have cluster headache but they are more common condition in men and they tend to start when a person is in their 30s or 40s. As the name says, this type of headache exhibits a clustering of painful attacks over a period of many weeks. [2] The pain of this type of headache peaks in about five minutes and it can last for 60 minutes. There are some people who suffer from cluster headache and they get them several times per day in a period of few weeks at a time but also there are some other cases when these people feel them for months. But usually these attacks are interrupted by a pain – free period and the length of this period can vary. It is known fact that more women suffer from migraines and more men suffer from the cluster headache.
Types of cluster headaches: In the most cases people are having their first cluster headache at age of 25 but also there are other cases when some people have their first cluster attacks in their teens but also others can have in their early 50s. There are two types of cluster headaches:
- Episodic: This type of cluster headache is more common. You may have 2 or 3 headaches a day for about 2 months and you may not experience another headache for a year. The pattern of this headache will repeat itself.
- Chronic: The chronic type of cluster headache behaves similarly but this person has no period of untreated sustained relief.
Symptoms of cluster headaches
This type of headache is beginning quickly and there is not warning. The pain is very severe and often it is described as piercing, burning or sharp sensation on one side of our heads. Often this condition is felt around your eye, temple and in some cases it can be felt on the face. This pain tends to occur on the same time each time when person has attack. When people are having attack, they are often feeling restless and agitated during an attack because their pain is so intense and they can have different reactions such as banging, pacing or rocking their head against the wall. At least one of the mentioned associated symptoms is usually present when we have cluster headache:
- A blocked or runny nostril
- A sweaty face
- A smaller pupil in one eye
- Dropping and swelling of one eyelid
- A red watering eye
The attacks of cluster headache usually last between fifteen minutes and 3 hours and they typically are happening between one and 8 times per day.
Causes for cluster headaches
What is the real cause for cluster headaches is not known but there are some studies in which the cause is linked to activity in any part of the brain which is called the hypothalamus. [3] Also it is said that people who smoke are having increased risk of getting cluster headaches. [4] There are some cases in which is said that the cluster headache is running in families which is suggesting that there may be is a genetic factor. [5] Also there are some cases when the cluster headache is triggered by drinking alcohol or by strong smells such as petrol, paint or perfume. [6]
Pattern of attacks: Cluster attacks are usually happening every day in bouts lasting several weeks or months at a time (typically four and twelve weeks) before they subside. Remission is a symptom – free period and it will often follow which in some cases it can last months or years before the headaches start again. Cluster headaches are usually happening at the same time every day. There are some people who often wake up with a headache within a couple of hours of going to sleep. Bouts are often happening every year for many years and they can be lifelong bouts. They are tending to happen at similar times of the year and most often is happening in the spring and autumn.
References:
[1] Wei DYT, Ong JJY, Goadsby PJ. Cluster headache: Epidemiology, pathophysiology, clinical features, and diagnosis. Annals of Indian Academy of Neurology. 2018;21(Suppl 1):S3–S8.
[2] Hattle AS. Cluster headaches cause years of needless pain. Nature. 2020. Retrieved from www.nature.com/articles/d41586-020-02866-5
[3] Qiu E, Wang Y, Tian L, et al. Abnormal brain functional connectivity of the hypothalamus in cluster headaches. PLoS One. 2013;8(2):e57896.
[4] Rozen TD. Cluster headache clinical phenotypes: Tobacco nonexposed (Never smoker and no parental secondary smoke exposure as a child) versus tobacco‐exposed: Results from the United States cluster headache survey. Headache. 2018;58(5):688-99.
[5] Gibson KF, Dos Santos A, Lund N, et al. Genetics of cluster headache. Sage Journals. 2019;39(10):1298-312.
[6] Imai N, Kitamura E. Differences in clinical features of cluster headache between drinkers and nondrinkers in Japan. Plos One. 2019. Retrieved from journals.plos.org/plosone/article?id=10.1371/journal.pone.0224407