Cluster Headache – Symptoms, Causes & Treatment

Cluster Headache, an uncommon and severe type of headache, is a one-sided head pain that involves a droopy eyelid, tearing and reddening of the eyes, and a stuffy nose. It lasts from 15 minutes to 3 hours and occurs in periods of frequent attacks. 

Known as trigeminal autonomic cephalgia, cluster headaches are unilateral in nature that follow a pattern and strike quickly.

In this blog, we have covered the causes, symptoms, diagnosis of cluster headaches and the treatment methods to prevent it.

Causes of Cluster Headaches

Being rare in occurence, cluster headaches can wake people from sleep. However, treatments and medicines can help reduce the number of cluster headaches. Approximately 0.1% of the global population is affected, i.e: approximately 1 in every 100,000 individuals gets impacted.

Here are some of the common causes of cluster headaches:

• Changes to high altitudes
• Nitrate foods such as lunch meat or bacon
• Bright light
• Strong smells
• Alcohol and cigarettes
• Exertion or exercises

Nevertheless, the exact cause of a cluster headache is unknown. Studies have discovered that the trigeminal nerve, responsible for transmitting sensations between the face and brain, releases certain chemicals that are relevant to the body. These chemicals include histamine, which is responsible for allergic reactions and serotonin, which provides communication between nerve cells. 

Furthermore, research say that cluster headaches occur if there’s a dysfunction in the hypothalamus. Additionally, it has been found that up to 5% of individuals can have heredity to cluster headaches. Ongoing studies aim to unravel the underlying causes of these headaches further.

How do cluster headaches differ from others?

In general, there are two types of headaches: primary and secondary. Primary headaches are related to the pain caused by the part of your brain, whereas secondary headaches are caused by other health conditions such as dehydration, nasal congestion, ear infections, etc.

Not every headache is a cluster headache. The following differentiation will help you better understand migraines, sinus headaches, and tension headaches:

• Migraines: A migraine causes recurring and throbbing pain and lasts for a few hours to a few days on both sides. But a cluster headache usually hurts on one side of your head. 
• Tension Headaches: It can last for 30 minutes to a few days and feels like a clamp squeezing your skull. It is an episodic kind that starts slowly in the middle of the day.
• Sinus Headaches: Being a sign of sinus infection, these headaches cause a dull pain behind your eyes, forehead, cheekbones, and nose.

Symptoms of cluster headaches

The main symptom of a cluster headache is an agonising pain on one side of the head, which occurs in clusters or cycles. People experience the following symptoms during a cluster head pain attack:

• Runny or stuffy nostrils
• Restlessness
• Droopy eyelids
• Sweating or flushing
• Smaller eye pupil
• Light sensitivity
• Mild feeling of burning
• Sudden onset of stabbing pain

Pattern of attacks

During a cluster period, headaches occur every day and last from one week to a year. People experiencing this kind of headache can feel irritated during daily routines and include an inability to complete personal obligations. Some cluster headaches occur seasonally, for e.g., during the spring or autumn and at the same time each year. Cluster headaches are of two types:

• Episodic cluster headache – The cluster periods last from 7 days to 1 year and are separated by pain-free periods known as remission. 
• Chronic cluster headache – If a cluster period persists for more than a year without remission or letup, then it is said to be a chronic cluster headache.

Cluster headache diagnosis

Cluster headaches are specific types of pain and attack. Its diagnosis solely depends on explaining the occurrence of pain, where it is located and how bad it is. Also the number of times the headaches happen, and the duration they last is also equally important.

A specialist or doctor who is trained in treating headaches will make a diagnosis based on symptoms, medical history, and a physical or neurological examination.

For people with complicated or unusual headaches, certain tests can be performed to understand the causes of cluster headaches:

• MRI scan: A magnetic resonance imaging (MRI) scan uses radio waves and a powerful magnetic field to produce in-detail brain and blood vessel images. MRI scans help diagnose strokes, tumours, brain bleeding, infections, and other conditions of the brain and nervous system. Conditions that affect the nervous system and brain are also called neurological conditions.

• CT scan: A computerised tomography (CT) scan uses multiple X-rays to generate detailed cross-sectional brain images. This helps diagnose infections, tumours, bleeding in the brain, brain damage, and other possible medical issues that cause headaches.

Treatment methods

You can treat cluster headaches with the following options:

• Medications for pain management during an attack
• Medications for headache prevention

1. Acute treatments (for pain management): When headaches occur, medications such as triptans, dihydroergotamine, octreotide, or lidocaine can help you relieve its symptoms. Also, breathing in 100% oxygen for up to 15 minutes with a face mask assists in pain relaxation during an attack.
2. Preventive treatments: These medications can shorten a headache cycle and stop it even before it starts. It makes the cluster less severe with medications used to treat blood pressure, seizures, and depression. 

Alternative therapies that may provide relief from cluster headaches include acupuncture, gammaCore – an external vagus nerve stimulator, physiotherapy, and spinal manipulation.

Below are some of the home remedies that you can use for temporary pain relief from cluster headaches. These are not proven and require additional research to take as evidence for the cure of cluster headaches.

• Melatonin supplements
• Topical capsaicin cream
• Oxygen therapy and box breathing exercise
• Magnesium supplements
• Kudzu extract

To sum up

Cluster headaches are painful and tend to reoccur often. The symptoms usually disappear within a few days but if it turns out to be a problem, it is better recommended to consult your doctor.

Along with the doctor-prescribed treatments, you can also try simple remedies for better results.

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