CLUSTER HEADACHE

The most severe of all headaches is CLUSTER headache. It is more common in men and especially in smokers. Its most important feature is that it is short-term. The pain usually lasts between 15 minutes and 3 hours. The pain is always on the same side and is unilateral. The pain is noticeable around the eyes, and can be reflected to the face, forehead and sometimes to the temple. During the pain, there may be redness in the eyes, watering, drooping eyelids, nasal congestion and runny nose on the painful side. The pain is in the form of a gouging, stinging and obsessive. It can recur up to 8 times a day. Attacks usually occur at night and can recur during the day. All pains are severe. There are two types: episodic and chronic. In the most common episodic type, the pain lasts for a few weeks to a few months during a certain period of the year (for example, in the spring), and sometimes the pain may not be seen for several years during the rest of the year. Being able to relieve it with oxygen therapy is an important distinguishing feature. It is a type of headache with a very high success rate in pain control with correct diagnosis and treatment.

In cluster headache patients, reducing or stopping alcohol and cigarette consumption, which are known to trigger attacks, especially during cluster periods, staying away from closed, stuffy places where smoking is done, choosing places with clean air and cool air, and avoiding daytime sleep are simple but important precautions that can be taken. Alcohol, nitroglycerin, exercise, and high ambient temperature are known precipitants of acute cluster attacks. In most patients with CBA, an acute attack is triggered within an hour after alcohol consumption (in migraineurs, it is triggered within a few hours). Alcohol triggers attacks during a cluster period, but it is not triggered in remission. Allergies, food sensitivities, hormonal changes, and stress do not have a significant attack-precipitating effect.

In cluster headache patients, reducing or stopping alcohol and cigarette consumption, which are known to trigger attacks, especially during cluster periods, staying away from closed, stuffy places where smoking is done, choosing places with clean air and cool air, and avoiding daytime sleep are simple but important precautions that can be taken. Alcohol, nitroglycerin, exercise, high ambient temperature are known precipitants of acute cluster attacks. In most patients with CBA, an acute attack is triggered within an hour after alcohol consumption (in migraineurs, it is triggered within a few hours). Alcohol triggers attacks during a cluster period, but not in remission. Allergies, food sensitivities, hormonal changes, and stress do not have a significant attack precipitating effect.

Attack treatment

• Oxygen therapy
• 5 HT1B/D agonists (sumatriptan, zolmitripan)
• Other treatments (octreotide, lidocaine)

Prophylaxis treatment

• Short-term (transitional) prophylaxis
• Corticosteroids
• Ergotamine preparations
• 5 HT 1B/D agonists