Cluster Headache

Question 1

Define cluster headaches

Answer 1

A neurological disorder characterized by recurrent, severe headaches on one side of the head, typically around the eye. There is often accompanying eye watering, nasal congestion, or swelling around the eye, on the affected side. These symptoms typically last 15 minutes to 3 hours. Attacks often occur in clusters which typically last for weeks or months and occasionally more than a year.

Question 2

What are the causes/risk factors of cluster headaches?

Answer 2

• smoking
• alcohol intake
• sleep apnoea
• history of head trauma
• family history

Question 3

What are the symptoms of cluster headaches?

Answer 3

at least 5 headaches fulfilling the following criteria:
• Severe or very severe unilateral orbital, supra-orbital, and/or temporal pain lasting 15 to 180 minutes if left untreated. The pain rapidly/ suddenly subsides
• Headache is accompanied by at least one of the following:
- Ipsilateral conjunctival injection and/or lacrimation
- Ipsilateral nasal congestion and/or rhinorrhoea
- Ipsilateral eyelid oedema
- Ipsilateral facial and forehead oedema
- Ipsilateral miosis and/or ptosis
- A sense of restlessness or agitation
• attacks have a frequency of one every other day to 8 a day

Question 4

What investigations are carried out for cluster headaches?

Answer 4

• CT/MRI - to exclude other causes
• ESR - to eliminate temporal arteritis
• pituitary function test - to exclude secondary cause from pituitary adenoma