Cluster Headache

Question 1

def

Answer 1

disabling headache

Question 2

aetiology

Answer 2

unknown

Question 3

risk factors/associations

Answer 3

male
family history
smoking

Question 4

epi

Answer 4

males>females
young adults
commoner in smokers

Question 5

what is an immediate trigger for cluster headaches during a cluster period

Answer 5

alcohol

Question 6

history

Answer 6

1 SEVERE unilateral orbital/temporal pain
-acute onset
-sharp or burning or pulsating
-occurs multiple times a day
2 associated lacrimation, rhinorrhoea, partial horners syndrome
3 occurs for a couple of months, disappears for a couple of months

Question 7

examination

Answer 7

agitation (pain is so severe few will be able to sit still)

Question 8

what will patients with cluster headaches be scared of

Answer 8

photophobia (light)

phonophobia (sound)

Question 9

investigations

Answer 9

1 CT/MRI
-normal in cluster headache
-abnormal may indicate secondary cause (tumour)
2 ESR

Question 10

what would investigating a patients ESR exclude

Answer 10

raised in giant cell arteritis in >50yrs