FAQ’s on Cluster Headaches
Typically localized to one side of the head, cluster headaches are very severe and painful headaches that occur in groups over a period of weeks or months. They can be painful enough to be debilitating, with the majority of patients experiencing multiple groups of headaches each year.
What are the causes of Cluster Headaches?
The primary causes of cluster headaches are not known. While under research, the only evidence for their causes has pointed to an association with both hereditary genes and alterations in the functionality of the brain. If one or both parents had cluster headaches, the likelihood of them being passed on increases exponentially.
What are the symptoms of Cluster Headaches?
The main symptom is a sharp or piercing pain on one side of the head. Pain typically begins in the temple, spreading into the eye and side of the head. The affected eye may swell, becoming watery, red, or puffy.
How are Cluster Headaches diagnosed?
Diagnosis can typically be achieved by examination of the symptoms present. Other tests, such as an MRI or CT scan may be used to confirm the presence of headaches. Neuroimaging while symptoms are present is a strong tool for diagnosing cluster headaches (The role of neuroimaging in the diagnosis of headache disorders, 2013).
What are the treatment options for Cluster Headaches?
There is not a direct cure for cluster headaches. Unlike migraines, cluster headaches cannot be prevented with medication. Treatment is taken at the beginning of a headache, and is instead focused on providing relief for the pain and on reducing the frequency and duration of attacks. Patients prescribed treatment by one of our physicians are strongly encouraged to take their medication at the first sign of symptoms with a goal of preventing the headache from worsening.
Medication: It is important to note that standard over-the-counter pain medication, including aspirin and ibuprofen, are typically not very effective in the treatment of cluster headaches. Instead, medication given is focused on preventing the headaches at the first sign of an attack (Cluster headache: conventional pharmacological management, 2013).
Oxygen: The inhalation of pure oxygen at the first sign of symptoms can assist in either mitigating or directly preventing the pain. Patients who respond well to oxygen treatment may be given a machine to keep with them so that they may use it whenever a headache is beginning.
Avoidance of Triggers: There are several things that can cause the occurrence of a headache during a cluster cycle. The avoidance of these items, called triggers, can assist in reducing the number of headaches experienced. Triggers include:
- Nitrates (found in wine, cheese, specific medications, and cured meats)
- Increase of internal body temperature
- Consumption of alcohol
- Irregular sleep patterns (Attempt to sleep at the same time, with the same duration, each day)
- Histamines (seasonal allergies may produce headaches)
Patients who do not respond well to preventative methods have a number of invasive options available.
Greater Occipital Nerve Block: For patients with either episodic or chronic cluster headaches, a greater occipital nerve block can be very effective in providing relief. By blocking the occipital nerves, located on the back of the head, the inflammation around the nerves can be reduced to provide symptomatic relief to headaches. Patients will receive an average of three blocks per month to assist in the management of their cluster headaches (Greater occipital nerve blocks in chronic cluster headache, 2013).
Vagus Nerve Stimulation: Patients who are having refractory cluster headaches can likely obtain relief via noninvasive simulation of the vagus nerve. Blocking this nerve has been shown to be a beneficial treatment for patients with cluster headaches (Vagus nerve stimulation for refractory cluster headaches, 2014). Patients who respond well to noninvasive vagus nerve stimulation may opt to have a stimulator implanted, providing a means for relief whenever headaches begin that they can directly control.