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Cluster Headaches
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
There are no clear-cut treatments for preventing cluster headache attacks, although steroids and a few other drugs may be effective in some cases (Greener, 2021). In lieu of prevention, pain may be reduced during an attack using a variety of treatments. Two of the more effective techniques are breathing from an oxygen tank and the use of nasal spray or injections containing serotonin-affecting drugs called triptans (Pearson et al., 2019). There are also several less effective methods, such as using caffeine or using capsaicin. Capsaicin is a component of hot peppers that gives them their spiciness. Putting a component of hot sauce in the nose first causes burning, as you might imagine, but in some cases then leads to a reduction in pain (Fusco et al., 1994). One type of medication that doesn't seem to work well at all is traditional opioid-based painkillers like morphine (Pearson et al., 2019).
Headache Disorders
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Cluster headache is a stereotypic episodic headache disorder marked by frequent attacks of short-lasting, severe, unilateral head pain with associated cranial autonomic symptoms.1 A cluster headache is defined as an individual attack of head pain, while a cluster period or cycle is the time in which a patient is having daily cluster headaches. Most cluster patients have episodic cluster headache, indicating that they will have remission periods in between cluster cycles, while a few unfortunate individuals have chronic cluster headache where cycles occur for more than 1 year without remission or with remission periods lasting <1 month.1
Neurology
Published in Shibley Rahman, Avinash Sharma, A Complete MRCP(UK) Parts 1 and 2 Written Examination Revision Guide, 2018
Shibley Rahman, Avinash Sharma
Paroxysmal hemicrania usually begins in early adulthood. As in adults, the differential diagnosis with cluster headache can be troublesome. The attack profile of paroxysmal hemicrania is highly characteristic. The frequency of attacks varies enormously within any 24-hour period. Attacks usually last between 2 and 25 minutes and occasionally as long as 60 minutes.
Cluster headache: a single tertiary center study
Published in Neurological Research, 2022
Zeynep Tuncer Issı, Nurcan Akbulut, Vesile Öztürk
In one study in Sweden, the age of onset of cluster headache ranged from 10 to 68 years, with a peak between 20 and 29 years for both sexes [16]. In a study conducted in the United States, it was stated that 36% of CH starts in the 21–30 age range, 35% were under 20 years of age, and only 3% were over 51 years of age [12]. In a large Italian study, it was stated that the average age of onset was 30.2. It was found that the classical male: female ratio reversed in the CCH patient group whose age of onset was before 16 years and after 49 years [17,18]. In studies conducted in Asian countries, the age of onset ranged between 26.7 and 37.9 [19]. In our study, the age of onset was found to be 31.68 ± 12.72 (13–68). There is no significant difference in the age of onset between the male and female gender.
Evaluating and managing severe headache in the emergency department
Published in Expert Review of Neurotherapeutics, 2021
Michelangelo Luciani, Andrea Negro, Valerio Spuntarelli, Enrico Bentivegna, Paolo Martelletti
There are other primary headache disorders that may present to the ED. Cluster headache is an easy diagnosis considering the clinical presentation with periodical attacks of severe, strictly unilateral pain, which is orbital, supraorbital or temporal, and lasting 15–180 minutes. The pain is typically associated with ipsilateral autonomic signs (nasal congestion and discharge, flushing, conjunctival injection, tearing, miosis, ptosis, restlessness, or agitation). Despite the headache attacks are short-lasting and self-limited, patients with cluster headache often visit the ED [50] and the main reason is because they are unaware of their condition and seek for a diagnosis. Patients with a known diagnosis may also visit the ED because of the inefficacy of the treatment prescribed as an outpatient; the urgent need of a drug prescription; an increase in the number of daily attacks since a few days; or a fear of adverse reactions because of the medication overuse due to a high daily frequency of the attacks.
A rational approach to migraine diagnosis and management in primary care
Published in Annals of Medicine, 2021
Vincent T. Martin, Alexander Feoktistov, Glen D. Solomon
The main differential diagnoses for migraine are tension-type headache and cluster headache [28]. Distinguishing features between these headache types include the typical location, quality, severity, and duration of pain, associated symptoms, and typical behaviour during attack, as shown in Figure 2 [32]. Briefly, tension headaches generally have mild-to-moderate, bilateral pain and lack migraine-associated symptoms (e.g. nausea and photophobia). Cluster headaches are associated with severe unilateral pain, ipsilateral autonomic symptoms (rhinorrhea, lacrimation, etc.), and duration <3 h. Medication overuse (≥15 days/month for simple analgesics; ≥10 days/month for triptans, ergots, combination analgesics or opioids) can increase the baseline frequency of any headache disorder and should be assessed once the primary headache is diagnosed.