What Causes Migraine And Cluster Headaches
Many experts believe that migraine and cluster headaches share a common cause that begins in the nerve that carries sensation from the head to the brain . Blood vessels on the brains surface expand , causing swelling in an area and pressure on nerve endings. The nerve endings submit signals to the brain to perceive pain. This may also explain some other symptoms associated with migraines, such as nausea, vomiting, and visual disturbances.
What You Need To Do
Develop a Pain Management Strategy With Your Doctor
Cluster headaches usually start at the same time every night, or every day. They are predictable in this way… even if you are episodic.
You know the pain phase is coming and you can often count the minutes it will last. Many times there is no warning before the pain phase hits.
Dealing with cluster migraine symptoms leading up to the pain phase is most distressing.
This is the time to take the medication your doctor prescribed, . The triptan family of drugs is really effective but you’ll need the injectable form or nasal spray. Pills are a disaster.
Read this PDF from Dr. Peter Goadsby on the Treatment of Cluster Headache , print it out and take it with you to your next physician’s appointment to help find the best medication possible.
Cluster headaches are a long, difficult journey. It may be hard to determine your trigger or triggers, and they are severely painful. If you are reading this page, then I suspect you already know this.
Please consider developing a migraine prevention pain management strategy with your doctor, so you can have the best life possible despite this condition.
Here are some other things that will be helpful to do.
Definition Diagnostic Criteria And Forms
Cluster headache is a primary headache disease like migraine or tension-type headache. By contrast to secondary headaches, in which the pain is symptomatic of an underlying brain, cranial or systemic disorder, primary headaches are due to spontaneous activation of nociceptive pathways. CH is characterized by recurrent attacks of short-lasting excruciating pain accompanied by signs of autonomic dysfunction, as described in the second version of the International Classification Headaches second edition criteria presented in table . The patient must have had at least five attacks of severe or very severe unilateral orbital or supraorbital and/or temporal pain, lasting 15 to 180 minutes if untreated. The headache is accompanied by one ipsilateral autonomic symptom among the following: conjunctival injection and lacrimation, nasal congestion or rhinorrhea, forehead and facial sweating, eyelid edema, miosis and ptosis. In the absence of autonomic signs, CH can be diagnosed if a sense of restlessness or agitation is present during the attacks.
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Change Language Reduce Stigma
The language used by medical experts, the media, the public, and stakeholders of this community can greatly impact how people living with headache diseases are perceived and treated. This, in turn, affects the resources society makes available to support the communitys pain and disability.
While Cluster Headache Is Side
Headaches can have many causes, some of which are innocuous. But sometimes, they need to be taken seriously. Dr C S Narayanan, VSM, head of department of neurology at Manipal Hospitals, New Delhi, says some of the red flags that would mandate detailed investigations are the onset of headache after 50 years of age, new onset of headache in those with an underlying medical condition or when the treating doctor finds abnormalities on clinical examination.
Those who have these so-called primary headache syndromes can have frequent, severe, and debilitating headaches that adversely impact quality of life. The most common headache that falls into this category is migraine, he explains.
According to the doctor, people are more familiar with migraine than cluster headaches because migraine is much more prevalent. One characteristic feature of migraine headache is it often affects one side of the head. Cluster headache, another common primary headache, shares this feature with migraine. While both are unilateral, cluster headache is side-locked, meaning it involves the same side in each attack, whereas migraine headache can shift sides, says Dr Narayanan.
Since the treatments for the two conditions are different, it is crucial to make the correct diagnosis.
Signs and symptoms of cluster headaches
Cluster headaches versus migraine
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Intensity Severity And Occurrence Of Cluster Headaches
Cluster headaches are significantly more painful than tension headaches. They can have been described as having a burning or even a piercing quality. These headaches come on very quickly with the pain becoming worse as time goes on. They often interrupt the flow of day-to-day activities, so it is important to seek a healthcare professional for treatment. However, they are not linked to underlying brain conditions .
As earlier stated, these headaches occur in clusters during one period of time. The sufferer, during that period of time, will have episodes multiple times a day for the duration. The headaches can last anywhere from half an hour up to three full hours. These episodes of cluster headaches can go through remission, but they tend to come back during the same season every year.
What Are Cluster Headache Symptoms
Cluster headaches tend to have very recognizable symptoms. When symptoms set in, it usually only takes 5 to 10 minutes for them to reach their worst. Common symptoms include one sided head pain and other symptoms involving the eye, nose and skin on the same side as the pain.
Pain from cluster headaches
Pain from cluster headaches has a few notable features:
- Often described as a burning or piercing feeling.
- Lasts 15 minutes to 3 hours at a time.
- Typically felt on the same side of the head in the current cycle rarely may switch in the future.
- Always centered behind one eye but can spread over the affected sides forehead, temple, nose and gums.
- Can make you feel like you cant sit still and need to pace, unlike the relief lying down provides for migraines.
Other cluster headache symptoms
Cluster headaches may also cause:
- Congestion: Your nose may run or become stuffy only on the side of the headache
- Eye problems: You may experience a drooping eyelid, eye pain or a watering eye. Your pupil may also look smaller. These symptoms appear on the same side of the head as headache pain.
- Face changes: You may start sweating and your face may become flushed on the side of the headache.
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Migraine Attacks That Group Together
Yes, migraine attacks can group together in time. In fact, research is increasingly showing that migraine frequency tends to be cyclical for many patients. Someone can go six months without a migraine attack, then have five in one month, then have a break before another spate of attacks. This is different from cluster headache. It doesnt mean a person has cluster migrainethey simply have migraine attacks that tend to group together in time.
Cluster Headache Vs Migraine
Cluster headaches are headaches that come in groups separated by pain-free periods of months or years.
- During the period in which the cluster headaches occur, pain typically occurs once or twice daily, but some patients may experience pain more than twice daily.
- Each episode of pain lasts from 30 to 90 minutes.
- Attacks tend to occur at about the same time every day and often awaken the patient at night from a sound sleep.
- The pain typically is excruciating and located around or behind one eye.
- Some patients describe the pain as feeling like a hot poker in the eye. The affected eye may become red, inflamed, and watery.
- The nose on the affected side may become congested and runny.
Unlike patients with migraine headaches, patients with cluster headaches tend to be restless. They often pace the floor, bang their heads against a wall, and patients can be driven to desperate measures including contemplating suicide.
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What To Do When You Have Cluster Headaches
To live with her headaches, Cindy uses breathable oxygen, as needed. She is a believer in alternative medicine, she says. Though other cluster patients may use oxygen, too, they typically also use some sort of preventative medication, such as verapamil, and something to try to stop the pain while theyre having it.
Distinguishing A Cluster Headache From Other Types Of Headaches
Cluster headaches usually start suddenly. A small percentage of people experience aura-like visual disturbances, such as flashes of light, before headaches begin.
Most commonly, headaches begin a few hours after you fall asleep and are often painful enough to wake you, but they may also begin when you are awake.
Headache pain becomes severe 5-10 minutes after the headache starts. Each headache usually lasts for several hours, with the most intense pain lasting between 30 minutes and 2 hours.
Cluster headache pain occurs on one side of the head, but can switch sides in some people, and is generally located behind or around the eye. It is described as a constant and deep burning or piercing pain. People with this pain say it is like a hot poker being stuck into your eye. The pain may spread to the forehead, temples, teeth, nose, neck, or shoulders on the same side.
Other signs and symptoms may be evident on the painful side of the head, including:
- a droopy eyelid
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Resources For Cluster Headache
Cluster headache resources are available through the National Organization of Rare Disorders . Cluster headache affects a small percentage of the population between 200,000 and 1 million people.2 It had been considered a rare condition but recently researchers have asked for this condition to be reevaluated because of its increasing prevalence. According to the National Institutes of Health a rare disease is defined as a condition that affects fewer than 200,000 people.
What Is Migraine Or A Cluster Headache
Although migraines and cluster headaches both cause severe pain in the head around the forehead, temples or sinuses, they typically feel and act differently.
A migraine is severe pain or throbbing, typically on one side of the head.
Cluster headaches are painful headaches that are shorter in duration but recur over a period of a few months and are followed by a period of remission up to a few years. People who suffer from cluster headaches tend to get them during the same season each year.
A migraine is a common condition that affects more than 37 million Americans, while cluster headaches are rarer and only affect approximately 1 million people.
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Barriers To Effective Care
Lack of knowledge among health-care providers is the principal clinical barrier. Worldwide, on average, only 4 hours of undergraduate medical education are dedicated to instruction on headache disorders. A large number of people with headache disorders are not diagnosed and treated: worldwide only 40% of those with migraine or TTH are professionally diagnosed, and only 10% of those with MOH.
Poor awareness extends to the general public. Headache disorders are not perceived by the public as serious since they are mostly episodic, do not cause death, and are not contagious. The low consultation rates in developed countries may indicate that many affected people are unaware that effective treatments exist. Half of people with headache disorders are estimated to be self-treating.
Many governments, seeking to constrain health-care costs, do not acknowledge the substantial burden of headache on society. They might not recognize that the direct costs of treating headache are small in comparison with the huge indirect-cost savings that might be made if resources were allocated to treat headache disorders appropriately.
Build A Cluster History
Write, write, write! The best way to document your disease is to write it down. Keeping a headache diary for at least three months will make it clear that your cluster disease is not only painful, but also prevents you from working even with treatment.
There is a treasure trove of resources out there to help you find your way. Together, we dont have to go it alone.
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How Are Cluster Headaches Diagnosed
Your doctor will ask you questions about your symptoms and give you a physical and neurological exam. This may include an MRI or CT scan of your brain to rule out other causes of the headaches, such as a brain tumor.
Treatment involves relieving and preventing your headache symptoms using medication. In rare cases, when pain relief and preventive treatment do not work, your doctor may recommend surgery.
Is It A Migraine Attack Or A Cluster Headache
Migraine and cluster headaches have different symptoms and require different treatments.
Whether youre having a migraine attack or a cluster headache, the pain it causes can be debilitating.
But because the treatments for the two diseases are very different, its crucial to figure out which you have or whether you have something else entirely to have the best chance at easing your pain.
Without the correct diagnosis, its difficult to find relief for your headache, says Merle L. Diamond, MD, associate director of the Diamond Headache Clinic in Chicago.
Heres what you need to know about the symptoms, causes, and treatment options for these two different types of headaches.
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How To Get Rid Of A Cluster Headache
Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology. She is an associate professor of neurology at Tufts Medical School and medical director of the Lahey Clinic Multiple Sclerosis Center in Lexington, Massachusetts.
Cluster headache is a rare but extremely debilitating disorder that affects about 0.1 percent of the population. Characterized by cluster periods of repeated, severe headache attacks of 30 or so minutes at a time, about 80% of cases are episodicmeaning a month or more time may pass between attackswhile the remaining 20% have no such breaks and are chronic. Treatments of this condition can be subdivided into those that are preventative in nature and those that take on headache and other symptoms after they start.
Because the exact mechanism of cluster headache is not fully understoodand due to the condition being relatively rare or often confused with migrainetheres no singular, gold-standard treatment. That said, there are a number of lifestyle, over-the-counter, prescription medication, and even surgical approaches to this condition. If you suffer from this condition, you may find the need to tailor an individualized approach with the help of your healthcare provider.
Verywell / Brianna Gilmartin
Pearls And Other Issues
- Cluster headaches are unilateral periocular headaches occurring between 15 minutes to 3 hours, with episodes usually occurring twice a day for weeks to months with remissions of months to years.
- There are associated autonomic symptoms on the ipsilateral side.
- Exact etiology and pathophysiology are unknown.
- Acute treatment includes oxygen and nonoral triptans.
- Prophylactic treatment is a suboccipital blockade.
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Find A Support Group And Get Extra Help
Cluster Headaches Have A High Rate of Suicide
If you are living with chronic or episodic cluster migraine headaches, you might find they effect every aspect of your life. You might find them unbearable and frightening, and have suicidal thoughts. That comes with this condition.
Your life can be affected because of decreased interaction with your friends and family. They may affect your ability to work full time.
People without cluster headaches may not understand how painful the attacks are and how much they can actually effect the overall quality of your life. Being isolated and misunderstood can lead to depression and suicide.
You are at greater risk as violent behavior and the propensity to self-harm are cluster migraine symptoms.
You may find encouragement and understanding in a headache support group or you may feel the need to talk with a professional pain counselor or therapist. Here’s who I recommend – Pain Counseling.
Either of these can help you to cope with the cluster migraine symptoms. There is a VERY good chance that the others in the group will be experiencing the same things as you are.
The exact cause of cluster headaches is unknown, so it’s hard to prevent the occurrence. It’s very important to have a preventive strategy because only treating the symptoms with medications can, at times, seem hopeless.
Here are two reputable websites:
- Clusterbusters.org in the US has a wealth of information for you to stay up to date on treatments and research.
New Findings About Cluster Headaches
- University of Texas Health Science Center at Houston
- Debilitating cluster headaches commonly begin in childhood, but patients are not typically diagnosed until they are adults, according to new research.
Debilitating cluster headaches commonly begin in childhood, but patients are not typically diagnosed until they are adults, according to research from The University of Texas Health Science Center at Houston .
A team of researchers led by Mark Burish, MD, PhD, assistant professor in the Vivian L. Smith Department of Neurosurgery with McGovern Medical School at UTHealth Houston, conducted the Cluster Headache Questionnaire, an international, internet-based survey of 1,604 participants with cluster headache. Results from the survey were recently published in Headache: The Journal of Head and Face Pain.
Cluster headache is a rare headache disorder, occurring in about one in every 1,000 individuals. They are extremely painful and occur in cyclical patterns known as cluster periods, with most attacks taking place at the same time each day. Cluster headache is diagnosed as “episodic” when the attacks occur in periods lasting between seven days and one year and are separated by pain-free periods lasting three months or longer. Meanwhile, in “chronic” cluster headache, attacks occur for more than one year without remission or with remissions lasting less than three months.
Other key survey findings include:
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