Cluster headache

  title={Cluster headache},
  author={Alexander David Nesbitt and Peter J. Goadsby},
  journal={BMJ : British Medical Journal},
Few, if any, medical disorders are more painful than cluster headache. Previously termed migrainous neuralgia, it was last reviewed in the BMJ nearly 50 years ago. At that time, the authors stressed the importance of covering the topic in a general medical journal to aid recognition. Despite this remarkably prescient view, and the extreme and stereotyped nature of its presentation, cluster headache is still commonly misdiagnosed. Without a clear diagnosis, affected patients can wait many years… 

Cluster headache: pathophysiology, diagnosis and treatment

The main focus of therapy is to abort attacks once they have begun and to prevent future attacks, and alternative interventions in patients with CH who have not experienced any meaningful benefit from preventive drugs are well defined.

Cluster headache: When to worry? Two case reports

The importance of clinical modifications of CH that could suggest clinical investigations should be performed or repeated to exclude a secondary pathology in a previously diagnosed cluster headache is highlighted.

Cluster Headache in Kuwait: A Hospital-Based Study

There is higher proportion of males compared to females and less positive family history in cluster headache patients referred to Headache Clinic in Kuwait, and smoking was a significant risk factor for chronicity in addition to advanced age, higher age at disease onset and a longer time taken till diagnosis.

Managing cluster headache

This article aims to guide general neurologists to an accurate diagnosis and practical management options for cluster headache patients.

Chronic persistent Horner’s syndrome in trigeminal autonomic cephalalgia subtypes and alleviation with treatment: two case reports

A chronic fixed partial or full Horner’s syndrome can occur in trigeminal autonomic cephalalgia subtypes, but it can also be reversed in patients with treatment even after months to years of duration.

Primary headaches.

Genetics of Cluster Headache and Other Trigeminal Autonomic Cephalalgias

Current knowledge of the genetics of cluster headache and other TACs are presented and factors potentially explaining why genetic studies were less successful than in migraine are discussed.

Clinical features of cluster headache without cranial autonomic symptoms: results from a prospective multicentre study

Among participants with PCH, headache intensity was less severe in participants without CAS than in those with CAS, and some clinical features of CH and PCH differed based on the presence of CAS.

Cluster Headache: Clinical Characteristics and Opportunities to Enhance Quality of Life

Greater understanding of the debilitating nature of cluster headache and behavioral interventions that seek to reduce the burden of the disease and improve the quality of life of people with cluster headache is paramount.

Can Psychedelics Alleviate Symptoms of Cluster Headache and Accompanying Mental Health Problems? A Case Report Involving Hawaiian Baby Woodrose

Preliminary evidence supports the efficacy of psychedelics in the alleviation of cluster headache and mental health problems and the first case report to concurrently examine the analgesic and psycho-spiritual effects of Hawaiian baby woodrose is described.



EFNS guidelines on the treatment of cluster headache and other trigeminal‐autonomic cephalalgias

Large series suggest that lamotrigine is the most effective preventive agent, with topiramate and gabapentin also being useful in treatment of SUNCT syndrome, and surgical procedures, although in part promising, require further scientific evaluation.

Treatment of intractable chronic cluster headache by occipital nerve stimulation in 14 patients

Improvement occurred within days to weeks for those who responded most and patients consistently reported their attacks returned within hours to days when the device was off and one patient found that ONS helped abort acute attacks.

Neuroimaging in trigeminal autonomic cephalgias: when, how, and of what?

A ‘typical’ clinical warning profile for secondary TACs is not identified as patients could present with clinical features that are entirely characteristic of a TAC, including alternating attack and attack-free periods, and excellent response to TAC-specific treatments.

Chronic cluster headache: a French clinical descriptive study

This study confirms the existence of auras and interictal signs and symptoms in patients with chronic CH, and male sex and smoking as CH risk factors, and primary and secondary chronic CH appear equally prevalent.

Intravenous dihydroergotamine for inpatient management of refractory primary headaches

The data suggest that IV dihydroergotamine given over 5 days produces improvement in headache and disability in patients with migraine more than shorter courses, and longer treatments produce a better outcome.

Interictal pain in cluster headache

Subjects with persistent interictal pain were more likely to have chronic cluster, allodynia, and suboptimal response to sumatriptan, suggesting that interdictal pain in cluster headache may predict a more severe disease process.

Nitrolglycerin as a provocative agent in cluster headache.

  • K. Ekbom
  • Medicine
    Archives of neurology
  • 1968
A definite method for provoking an attack would therefore be of value, from both the diagnostic-therapeutic and the pathophysiological aspects, to establish the mechanism of the actual headache.