Cluster headache

Cluster headache is a type of primary headache that presents with "whipping" pain, which has very strong intensity. The patient may find that the pain worsens at rest or when lying down, and moving about could help to ease the pain. The symptoms are commonly experienced at night: the pain is usually located temporally or periorbital, unilaterally and is accompanied by lacrimation, nasal secretions and Horner's syndrome. Symptoms of cluster headaches tend to manifest within a few days of the year, often in the spring and fall seasons.

Diagnosis
The diagnostic criteria are shown in the table: When taking the medical history of the patient, it is necessary to evaluate the following key information associated with the headache:


 * Nature of pain (dull, pulsating, whipping)
 * Location of pain (hemicrania, diffuse, behind the eye)
 * Intensity
 * Duration (seconds, hours, days, daily pain)
 * Frequency of pain (several times a day, monthly)
 * Other accompanying symptoms (phonophobia, photophobia, odorophobia, lacrimation, nasal secretion, cerebral nerve palsy, hemiparesis, cerebellar symptoms, impaired consciousness)
 * Triggering factors (physical activity, defecation, head tilt, stress, menstruation, drugs, alcohol)
 * Factors that could alleviate the pain

Treatment

 * Oxygen inhalation and sumatriptan are used therapeutically.
 * In severe cases, corticoids are administered.
 * The differential diagnosis include dissection of the carotid artery and rupture of aneurysm - MRI, angiography and ultrasound are the diagnostic methods that could be conducted.

Related links

 * Cluster headache/PGS