Cluster Headache – Symptoms and Causes
Overview
Cluster headache causes severe pain near one eye on one side of the head. These headaches occur in patterns called clusters, with frequent attacks for weeks or months followed by pain-free periods that might last months or years.
The intense pain can interrupt sleep and significantly impact daily life. Though cluster headache is not common, several treatment options exist.
Medications can help reduce both the severity of individual attacks and their frequency during cluster periods. Early recognition and proper treatment can help people manage this condition more effectively and minimize disruption to their lives.
Signs and Indicators
Cluster headaches hit fast without warning. Some people might feel sick or see visual changes first, like with migraines.
During a cluster headache, you might experience:
- Severe pain, often described as sharp or stabbing, typically centered in or around one eye.
- One-sided pain that may switch sides in different cluster periods.
- Physical restlessness (unable to sit still).
- Excessive tearing from the affected eye.
- Red eye on the painful side.
- Nasal congestion or runny nose on the painful side.
- Sweating on the forehead or face.
- Skin color changes on the affected side of the face.
- Swelling around the eye on the painful side.
- Drooping eyelid on the painful side.
The pain can be so intense that many people pace or rock back and forth during an attack.
Attack Patterns
A cluster period typically continues for several weeks up to a few months. These periods often follow a predictable pattern, occurring during specific times of year like spring or fall.
Most people experience cluster periods lasting between one week and one year. After this comes a pain-free time called remission that lasts at least three months before another cluster period begins. This pattern is called episodic cluster headache.
If cluster periods last longer than a year with pain-free periods shorter than one month, this is considered chronic cluster headache.
During a typical cluster period:
- Headaches usually occur daily, often multiple times per day
- Each attack lasts 15 minutes to 3 hours, but typically 30-45 minutes
- Attacks often happen at the same time each day
- Most attacks occur at night, typically 1-2 hours after going to bed
The pain typically stops as suddenly as it began. After an attack, most people feel exhausted but pain-free.
When to Contact a Healthcare Provider
See a doctor if you start experiencing cluster headaches. They can rule out other conditions and recommend appropriate treatment.
While severe headache pain usually isn’t caused by another illness, headaches can sometimes indicate a serious medical condition like a brain tumor or blood vessel tear.
If you already have a history of headaches, contact your doctor if the pattern or feeling of your headaches changes.
Seek emergency medical care immediately if you experience:
- A sudden, extremely severe headache that feels different from usual headaches
- Headache with fever, nausea, vomiting, stiff neck, confusion, seizures, numbness or speech problems
- Headache after a head injury that gets worse, even if the injury seemed minor
- A headache that steadily worsens over days
- Any sudden, severe headache unlike any you’ve had before
These symptoms could indicate a medical emergency requiring immediate attention.
What Causes Cluster Headaches
Scientists aren’t certain what causes cluster headaches. Research points to problems in the hypothalamus, the brain region that controls our body’s internal clock.
Several factors can set off cluster headaches:
- Alcohol consumption is the most common trigger
- Weather changes may prompt attacks
- Certain medications can trigger episodes
- Changes in sleep patterns
- High altitudes
- Strong smells or chemicals
Many people with cluster headaches learn to identify their personal triggers and avoid them when possible.
Risk Factors
Several factors may increase your chance of having cluster headaches:
- Gender: Men have a higher risk than women.
- Age: Most cases start between ages 20-50, though they can begin at any age.
- Tobacco Use: Smokers face higher risk. However, quitting doesn’t necessarily stop the headaches.
- Alcohol Consumption: Drinking during a cluster period might trigger an attack.
- Family Connections: Having a close relative (parent or sibling) with cluster headaches may increase your risk.
These factors don’t guarantee someone will develop cluster headaches, but they’re linked to higher chances of experiencing this painful condition.
