Cluster Headache

Cluster headaches are recurrent, severe headaches that occur in "clusters" during periods of time called cluster periods or episodes. In fact, the vast majority of headaches are primary headaches headaches that aren't caused by a specific medical condition. These include migraines, tension-type headaches and cluster headaches. The headaches may disappear completely (go into "remission") for months or years, only to recur. A cluster headache typically awakens a person from sleep 1 to 2 hours after going to bed. Cluster headaches have an abrupt onset and can happen at any time, but they most commonly occur two to three hours after falling asleep, usually during the phase of deep sleep known as rapid eye movement (REM). Fortunately, cluster headache is rare, affecting less than 1 percent of the U.S. population. The condition is more common in men. Cluster headache can affect people at any age but is most common between adolescence and middle age. During a cluster period, an individual is more prone to having the headaches and may have several headaches every day. During a cluster headache cycle, the attacks of severe pain often occur at the same time each day. Although cluster headache attacks are extremely painful, they're not life-threatening. Several treatments are available to help make the attacks shorter and less severe. In addition, preventive medications can help reduce the number of headaches.

The headache is always unilateral, excruciating, and most uniquely, in timed attacks called "clusters." Cluster headaches affect one side of the head (unilateral) and may be associated with tearing of the eyes and nasal congestion. Cluster headaches are characterized by intense burning and boring pain, frequently located in or around one eye and temple and occasionally in one cheek or jaw. Other features can include reduced pupil size, a drooping eyelid and a flushed face. The pain swiftly intensifies within 5 to 10 minutes to a peak that typically persists for 30 minutes to 2 hours. They usually last for less than two hours. The headaches can occur daily for days, weeks, or months before a remission period that can last weeks or years (episodic attacks), or can occur for a year or more without remission (chronic attacks). A chronic phase may begin after a period of episodic attacks.

Causes of Cluster Headache

The common Causes of Cluster-Headaches :

• Some medications (such as nitroglycerin)
• Heavy smoking
• An interruption in your normal sleep pattern
• In this form, cluster headache occurs daily for more than a year with no remission or with pain-free periods lasting less than two weeks.
• problems with the hypothalamus, which controls your body's "biological clock"
• In this form, cluster headache occurs daily for one week to one year, followed by a pain-free remission period lasting weeks to years before another cluster period develops.
• Tension may strain muscles of the face, neck, and scalp, leading to the tight, pressing pain sensation of tension-type headaches.
• While the basic cause of cluster headache is not known, current research links the expanding of blood vessels in the head with chemically active proteins found in nerve endings around blood vessels of the trigeminal nerve (the fifth cranial nerve).

Symptoms of Cluster Headache

Some are common Symptoms of Cluster-Headaches :

• Swelling under or around the eyes (usually one eye, on the same side as the head pain).
• Red eye (on the affected side).
• May occur in and around one eye .
• Stuffy or runny nose.
• Red, flushed face.
• May involve one side of the face from neck to temples.
• Reduced pupil size.
• Burning or boring pain
• Characteristically occurs on one side of the head

Treatment of Cluster Headache

• The numbing effect of local anesthetics, such as lidocaine (Xylocaine), may be effective against cluster headache pain when used in the form of nasal drops.
• Response can vary over time, so a previously taken effective medication or combination of medications may not have the same effect.
• This may be an option for people with chronic cluster headaches who have not been helped with standard therapy. Most of the procedures involve blocking the trigeminal nerve.
• Inhalation of high-flow, concentrated oxygen
• Injection of Depo-Medrol
• Different types of surgery have been used over the years to treat chronic cluster headaches, but those which deaden the pain-sensitive cells of the fifth cranial nerve have worked best.
• Imitrex injection
• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Naprosyn
• However, a small number of patients have a chronic form of cluster headache which is resistant to medical therapy and therefore very difficult to treat.