Cluster headache

Question 1

What is cluster headache?

Answer 1

episodic, excruciating, unilateral behind the eye,

Question 2

What are symptoms for a cluster headache?

Answer 2

1. Lacrimation
2. Rhinorrhoea
3. Partial Horner’s (ptosis, miosis)
4. Red, swollen eyes
5. Sweating
6. 15mins-3hr

Question 3

What are RF for cluster headaches?

Answer 3

1. Male sex
2. Family history
3. Heavy smoking
4. Heavy drinking

Question 4

What are DDx for cluster headache?

Answer 4

1. Migraine without aura

2. Angle-closure gluacoma

Question 5

What investigations are done for cluster headache?

Answer 5

No investigations specific for cluster headaches
Most investigations are investigations of exclusion
- MRI -> exclude anything more sinister
- ESR -> exclude giant cell arteritis
- Pituitary function tests -> pituitary adenoma

Question 6

What is the acute treatment of cluster headache?

Answer 6

1. Subcutaneous Sumatriptan 6mg

2. High-dose, high-flow O2