HA- Cluster

Question 1

Cluster HA Diagnosis

Answer 1

Severe or very severe unilateral orbital, supraorbital, and/or temporal pain lasting 15-180 minutes (when treated)

Either or both of the following:
At least 1 of the following symptoms or signs, ipsilateral to the HA:
Conjunctival injection and/or lacrimation
Nasal congestion and/or rhinorrhea
Eyelid edema
Forehead and facial sweating
Miosis and/or ptosis
Sense of restlessness or agitation
Occurring with a frequency between 1 every other day and 8 per day

Question 2

Cluster HA patho

Answer 2

Trigemonivascular system activation, trigeminal-autonomic reflex, posterior hypothalamus activation

Question 3

Cluster HA symptoms

Answer 3

Extremely intense pain on one side of the head (usually periorbitally)
Accompanied by ipsilateral autonomic symptoms (conjunctival hyperemia, increased lacrimation, rhinorrhea and nasal congestion, swelling around the eye. ptosis)
Pacing or agitiation

Question 4

Risk factors for cluster HA

Answer 4

Genetics, tobacco use, history of head trauma

Question 5

Acute treatment of cluster HA

Answer 5

O2, SQ or intranasal sumatriptan, intranasal zolmitriptan

Question 6

Preventative treatment of cluster HA

Answer 6

VERAPAMIL!!
Glucocorticoids, galcanezumab, lithium, topiramate, greater occipital nerve blocks