Cluster Headache

Question 1

What is a cluster headache?

Answer 1

Recurrent, severe headaches on 1 side of the head typically around the eye, tending to recur over a period of several weeks.

Question 2

What is the aetiology of cluster headaches?

Answer 2

UNKNOWN aetiology

Question 3

Describe the epidemiology of cluster headaches

Answer 3

M > F

Peak: 20-40 yrs

Question 4

What are the 2 types of cluster headache?

Answer 4

Episodic: 1 week- year, followed by a pain-free remission period lasting as long as 12 months before another develops.
Chronic: >1 year without remission/ short remission

Question 5

Describe the pain experienced in cluster headaches

Answer 5

Rapid onset ~10 mins
Intense, sharp + penetrating
Centred around the eye, temple or forehead
Unilateral
Lasts ~45-90 mins (range: 15 mins - 3 hours)
Occurs once or twice daily

Question 6

Describe the associated ipsilateral symptoms of cluster headaches

Answer 6

Lacrimation
Conjunctival injection  
Rhinorrhoea  
Nasal congestion  
Partial Horner's syndrome

Question 7

What investigations should be performed for cluster headaches?

Answer 7

CLINICAL dx based on hx

Neurological examination may be useful

Question 8

List 6 triggers/ associations/ risk factors of cluster headaches

Answer 8

ALCOHOL
Head trauma
Smoking 
Sleep disruption
Solvents 
FH

Question 9

What are the 3 cardinal features of cluster headaches?

Answer 9

Trigeminal distribution of the pain
Ipsilateral cranial autonomic symptoms
Circadian/ circannual pattern of attacks.