Cluster Headaches
Overview
Cluster headaches occur as groups of headaches (clusters), and are less common than migraine or tension headaches. Unlike migraines, men are more likely than women to develop this type of headache.
Symptoms of cluster headaches includes pain that:
- Occurs on one side of the head.
- Can continue for days, weeks, or months.
Treatments include medications and oxygen therapy.
Symptoms
You may have cluster headaches if your pain:
- Is sudden and disabling in the forehead and eye on just one side of the head. The pain can shift to the other side of the head the next time the headache occurs.
- Is burning, or sharp and piercing.
- Gets worse quickly and lasts from 30 minutes to several hours.
Other symptoms can accompany the headache. They occur on the same side of the head as the pain and include:
- Droopy eyelid
- Pupillary changes
- Watery, red eye
- Runny or stuffy nose
A cluster of headaches can continue for days, weeks, or months. Once the cluster stops, you may not have another one for months or years.
Cluster headaches usually recur at the same time of day, and even the same season. Sometimes, cluster headaches become chronic and continuous.
Causes and Risk Factors
We don’t know the exact cause of cluster headaches. The latest research suggests that they start from activity in the hypothalamus, a structure deep inside the brain that helps control the nervous system, sleep, and emotions.
Other possible triggers include:
- Genetics. People with a family history of cluster headaches are more likely to get them.
- Trigeminal nerve. This nerve seems to be more active in people who have cluster headaches. It controls sensation in the face, forehead, chin, and jaw.
- Tobacco/alcohol use. Most people with these headaches are heavy smokers and/or regularly consume alcohol.
- Circadian rhythms. These headaches often occur at the same time of day, and tend to recur around the same time of the year. This suggests that the body's natural clock may play a role in causing these headaches.
Diagnosis
We’ll ask you about your symptoms and medical history. We’ll also examine you to make sure that your symptoms are not caused by a more serious underlying illness.
We may recommend additional tests if:
- Headaches are a new problem for you.
- You have a change in your symptoms.
- Your exam indicates you may have another condition.
Some headaches are caused by depression. We will also evaluate you for depression during your examination.
Treatments
Cluster headaches can’t be completely cured. However, treatment can make them less severe and go away more quickly.
Medications
Some medications can prevent a cluster of headaches from starting. Others can stop, or shorten, the headache once it has started.
In addition, certain medicines can be used to treat the individual headaches or control the clusters. These can include:
- Antiseizure medicines
- Certain blood pressure medications
- Steroids
- Antidepressants
- Triptans
Some headache medications are not recommended during pregnancy. Talk to us if you’re:
- Considering getting pregnant.
- Currently pregnant and taking medications to control your headaches.
Other treatments
We may also recommend oxygen therapy (breathing in oxygen), which can be effective for treating a cluster headache once it is underway. Oxygen therapy increases blood flow to the brain and can decrease the headaches.
When to Call Us
If any of the following occur, call our 24-hour Appointment and Advice line immediately:
- Your first serious headache occurs after age 50.
- You have new, severe symptoms unlike your usual headache symptoms.
- You have the worst headache you have ever experienced.
- Your headaches are getting worse over time.
- Your headache gets worse with exertion, or with coughing, sneezing, or sexual activity.
- You feel drowsy, feverish, or suddenly weak.
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Disclaimer
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.