Cluster Headache: Symptoms, Causes, Treatment, Diagnosis

What is a Cluster Headache?

Cluster headache is a serious and very painful condition. Cluster headache is a one sided pain of the head. It is also described as a pain which occurs around the eye or behind the eye in a cyclic pattern. Sometime this pain feels like a drilling in the head. Cluster headache is a very rare type of headache that affects 1 to 2 people in a thousand.

Symptoms of Cluster Headache

Symptoms of Cluster Headache

The symptoms of cluster headache are distinguished by the unilateral pain or one sided pain. Generally, this pain centers on one eye, either left or right and it can unfurl to a larger part. Cluster headache frequently starts at night. Cluster headache reaches to the peak level in 5 to 15 minutes and the pain subsides between 30 to 60 minutes. The time period of this pain is not fixed. In case of some people, pain goes off in 15 minutes while some experience the pain for 3 hours.

Approximately 80% of people with cluster pain feel a drilling sensation in the head or the bouts of pain for 28 to 84 days in a year continuously or with a gap. Remaining 20% people experience “chronic cluster headache” and the pain remains almost always.

Some Other Symptoms Of Cluster Headache Are As Follows:

  • Running (rhinorrhea) or blocked nose
  • Droopy and watery eyelid
  • Red eyes
  • Swelled and flushed face.

When the intensity of cluster headache is very high, patient feels pain along the forehead and it extends into the ear to shoulder with neck. Some patients only suffer from some redness. Cluster headache cycle may get over in a single day or may persist for longer periods or many weeks. For some people, the part of head affected by pain can vary from one time to another; however, it is totally a unilateral pain.

Causes of Cluster Headache

The specific cause of cluster headache is not identified. Based on MRI studies, it was found that in some patients’ hypothalamus could contribute to cluster headache. Some doctors opine that cluster headache and migraine headache have same causes because trigeminal nerve is responsible for the pain sensation surrounding the brain. While some other doctors believe that cluster headache comes from the deeper part of the brain like cavernous sinus and deny the role of the trigeminal nerve. Some major causes of cluster headache are given below:


65% of patients experiencing cluster headache are found to be addicted to tobacco consumption. However, this cannot be considered as the sole cause since children also suffer from cluster headache.


Cluster headache mostly occurs within a fix time interval in a day or in a week and this repeating cycle comes with biological clock. It was also noted that people with cluster headache have structural changes in hypothalamus.

Some other risk factors of cluster headache are stress, extreme temperatures, Hay fever and family problems. Sometime, it is also caused by eating certain foods or due to consumption of alcohol or tobacco.

How is Cluster Headache Diagnosed?

Diagnosis of cluster headache is done based on the following factors:

  • Type of pain
  • Pattern of attacks
  • Location of pain.
  • It is easily diagnosed if the associated symptoms clearly show.
  • Time period.

Time period is an important factor for diagnosing cluster headache. It is simply diagnosed, if patient defines that how many time headache occurs and the time for which it persists.

Sometime, neurologist advices some diagnostic tests which helps in diagnosing the condition properly. The tests are as follows:

  • MRI Scan: In MRI, very high magnetic field and radio waves are used to get the detailed images of the brain and blood vessels in the form of images which helps in the diagnostic process.
  • CT Scan: In this test, a series of X-rays are used to create the cross sectional image and information about your brain. It is the basic test for diagnosing critical cluster headache.

Treatment for Cluster Headache

Generally, the treatment of cluster headache is divided into two parts. One is the short time relief while second treatment for cluster headache is preventing the onset of headache in the future. The oxygen face mask is the basic treatment of cluster headache for short time period. Another very beneficial treatment for cluster headache is the medicine sumatriptan. It is available in all three forms – nasal spray, oral tablets and injection. The sumatriptan injection is the most beneficial and effective for the treatment of the cluster headache.

Intranasal lidocaine is another option for the treatment of cluster headache. However, careful administration and precaution is to be taken for taking this medicine. In some cases, doctors suggest surgery to decrease the episodes of cluster headache. To reduce the intensity of headache for a short time, some other medicines are also used and they are as follows:

  • Dehydroergotamine
  • Valproic acid
  • Topiramate
  • Melatonin
  • Lithium and verapamil.

Some types of therapies that have been helpful to decrease the cluster headache attacks are acupuncture, osteopathic manipulation.


Cluster headache can be really difficult to handle as the pain experienced is often excruciating and long lasting. It is important to get an evaluation done by a doctor to get a proper diagnosis on the condition. Cluster headache can be easily managed with proper treatment.

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 8, 2017

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