What can trigger Cluster Headaches?

Certain factors that can trigger cluster headaches are: Stress, relaxation Hot or cold environments Glare Hay fever Sexual activity Certain foods Tobacco and alcohol

Cluster headache treatment · St. Louis

Cluster Headache Treatment

Cluster headaches are fierce headaches in or around one eye on one side of the head. They strike daily in cycles that last weeks to months, then go quiet for a while. There is no cure. So Padda Institute doctors manage the attacks and work with your family doctor on your care.

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What is a cluster headache?

Cluster headaches are among the most intense headaches. They come in cycles, or clusters. The pain sits in or around one eye on one side of the head. For example, you might feel a fierce headache behind the left eye. Cluster spells last weeks to months. They are often followed by remission, when the headaches stop. In remission there are no headaches for months or even years. Cluster headaches are not common, and they are not a danger to life. With the right care, attacks can be made shorter and less severe. Medicine can also help cut how often they come. There are two main types: episodic cluster headaches and chronic cluster headaches.

Who treats cluster headaches when standard treatment has not worked?

A pain physician who blocks the nerve pathway that drives the attack. Cluster headache runs through the trigeminal nerve and the sphenopalatine ganglion, a nerve cluster behind the nose. When oxygen, triptans and verapamil have not broken the cycle, the next step is a nerve block: a sphenopalatine ganglion (SPG) block, an occipital nerve block or a stellate ganglion block.

The SPG block goes in through the nose with no sedation, and most patients drive themselves home. Opioids do not stop an attack and are not part of the plan. How to stop a cluster headache covers what works within minutes.

How long do cluster headaches last?

A cluster phase can last from a few weeks to several months. Each cluster period may start at the same time and last as long as the one before. For example, cluster periods can come back every spring or every fall. Episodic cluster headache is the more common of the two types. Episodic cluster periods last from a week to a year. Then comes a remission that can last up to a year before the headaches return.

Headaches occur daily, sometimes many times a day.
An attack can last from 15 minutes to three hours.
Attacks often happen at the same time every day.
Most attacks occur at night, 1 to 2 hours after bed.
The pain leaves as fast as it came, dropping off all at once. Most people are pain-free but worn out after an attack.

What does a cluster headache feel like?

You may first feel migraine-like nausea and an aura. Then a cluster headache strikes fast and without warning. These are some of the most common signs and symptoms:

Headache on One Side

Redness and Swelling

Runny Nose

Neck Stiffness

Sweating

Anxiety

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How is a cluster headache diagnosed?

Cluster headache pain and attacks follow a clear pattern. To get the right diagnosis, describe your headache. Say where the pain is, how bad it is, and any other symptoms you have. How often the headaches come and how long they last also matter. Your doctor will use a few methods to find the type and cause of your headache.

Neurological Examination

A neurological (nerve and brain) exam can help your doctor spot neurological disorders. In people with cluster headaches, this exam is usually normal. Your doctor will test your senses, reflexes, and nerves to see how well your brain works.

Imaging tests

A doctor may suggest scans if your headaches are unusual or complicated, or if your exam is abnormal. This rules out other serious causes of head pain, such as a tumor or an aneurysm (a bulging blood vessel). Common brain scans include:

MRI

It makes detailed pictures of your brain and blood vessels with a strong magnet and radio waves.

CT Scan

It uses X-rays to build detailed cross-sectional pictures of your brain. The doctors at Padda Institute are highly trained to diagnose and treat all types of headaches, including cluster & chronic headaches. They will work with your family doctor on your care and make sure you get full cluster headache pain relief.

Your Padda Institute Care Team

Research at the Padda Institute has made significant advances in how we understand different types of headaches. Our cluster headache specialists treat many people each year so they can live the life they deserve.

The Team Approach

A team of Padda Institute neurologists may see and treat you, along with your own doctor.

Individualized Care

Picking the right treatment is a team effort between you and the doctors at Padda Institute. There is no cure for cluster headaches, but our doctors will help you manage them.

Care Coordination

Your doctor and your family doctor will plan your care together.

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Frequently Asked Questions

Cluster headache is a primary headache disorder: the headache is the disease, not a symptom of something else. It is diagnosed from its pattern, which is one-sided pain around the eye lasting 15 minutes to three hours, a watering eye or runny nostril on the same side, and attacks that return at the same time of day. A neurologist or a headache-focused pain physician makes the diagnosis. Here the physician who makes it also performs the nerve blocks, and scans are used only to rule out other causes when the pattern is unusual. Learn more: why the eye waters and the nose runs during an attack.

Padda Institute does. Ordinary headache medicines, including ibuprofen, acetaminophen and opioids, are too slow for an attack that peaks within minutes. The plan here covers three levels: the attack, with high-flow oxygen and fast-acting triptans; the cycle, with a steroid bridge and preventive medicine; and the nerve itself, with SPG, occipital and stellate ganglion blocks. Learn more: SPG and stellate ganglion blocks for cluster headache.

Less than 1% of people have cluster headaches. Men get them far more often than women. Attacks seem most common in middle-aged people.

People with cluster headaches should take their drugs at the times and doses their doctor sets. They should learn all possible triggers and stay away from them.

The International Headache Society (IHS) sorts cluster headaches into two kinds. Episodic ones come back in cycles. Chronic ones go on long-term without real breaks.

Certain factors that can trigger cluster headaches are:

Stress, relaxation
Hot or cold environments
Glare
Hay fever
Sexual activity
Certain foods
Tobacco and alcohol

A cluster headache attack comes on suddenly. The pain usually peaks within a few minutes, but attacks can last up to 3 hours. Unlike migraine, cluster headaches do not come with auras (changes in sight or other senses). So most patients get little or no warning. Cluster headaches also differ from other headaches because they often start while a person is asleep.

A single attack does not last for days. Each attack runs from 15 minutes to three hours, and the pain fades as quickly as it came. What lasts is the cluster period: attacks return daily, sometimes many times a day, for weeks to months. Episodic cluster periods run from a week to a year. Then a remission follows that can last up to a year.

There is no cure for cluster headaches, but they can be managed. With the right care, attacks get shorter and less severe. Medicine can cut how often they come. You and your Padda Institute doctor choose the treatment together. Your part is taking your drugs at the times and doses your doctor sets, and staying away from your known triggers.

Cluster headaches keep a schedule. Attacks often come at the same time every day. Most arrive at night, one to two hours after going to bed, so many start while a person is asleep. The cluster periods can follow the seasons too. They may return every spring or every fall, with a similar start time and length each cycle.

Cluster headaches are among the most intense headaches a person can have, but they are not a danger to life. Your headaches may be unusual or complicated, or your neurological exam may be abnormal. Then your doctor may order an MRI or a CT scan of the brain. That rules out other serious causes of head pain, such as a tumor or an aneurysm.