Cluster Headaches Characteristics

Cluster headaches, which occur in cyclical patterns or cluster periods, are one of the most painful types of headache. A cluster headache commonly awakens you in the middle of the night with intense pain in or around one eye on one side of your head.


Bouts of frequent attacks, known as cluster periods, can last from weeks to months, usually followed by remission periods when the headaches stop. During remission, no headaches occur for months and sometimes even years.Fortunately, cluster headache is rare and not life-threatening. Treatments can make cluster headache attacks shorter and less severe. In addition, medications can reduce the number of cluster headaches you have.


You get a cluster headache when a nerve pathway in the base of your brain is triggered. That signal seems to come from a deeper part of the brain called the hypothalamus, home of the "internal biological clock" that controls your sleep and wake cycles. The nerve that's affected, the trigeminal nerve, is responsible for sensations such as heat or pain in your face. It's near your eye, and it branches up to your forehead, across your cheek, down your jaw, and above your ear on the same side. A brain condition, such as a tumor or aneurysm, won't cause these headaches.






Characteristics of Cluster Headaches


There are a few things that set this type of headache apart. They include:


Speed. Cluster headaches generally reach their full force quickly, within 5 or 10 minutes.


Pain. It’s almost always on one side of your head, and it stays on the same side during a period, the time when you're getting daily attacks. It's often described as a burning or piercing. It may be throbbing or constant. You'll feel it behind or around one eye. It may spread to your forehead, temple, nose, cheek, or upper gum on that side. Your scalp may be tender. You can often feel your blood pulsing.


Short duration. Cluster headaches usually last only 30 to 90 minutes. They can be as short as 15 minutes or as long as 3 hours, but then they disappear. You'll probably get one to three of these headaches a day. Some people have as few as one every other day, while others get them up to eight times a day.


Predictable. Attacks seem to be linked to the circadian rhythm, your body's 24-hour clock. They happen so regularly, generally at the same time each day, that they've been called "alarm clock headaches." They might even wake you up an hour or two after you go to bed. Nighttime attacks can be more severe than daytime ones.


Frequent. Most people will get daily headaches for 2 weeks to 3 months; in between these periods, they'll be pain-free for at least 2 weeks.




Symptoms


The pain usually starts suddenly. You may notice:


Discomfort or a mild burning feeling

A swollen or drooping eye

A smaller pupil in the eye

Eye redness or watering

Runny or congested nose

Red, warm face

Sweating

Sensitivity to light



Cluster headaches are more common in people who smoke or who are heavy drinkers. During a cluster period, you'll be more sensitive to alcohol and nicotine. Just a bit of alcohol can trigger a headache. But drinking won't trigger one during headache-free periods.




Triggers


When you’re in a cluster period, any of these can bring on a headache:


Cigarette smoke

Alcohol

Strong smells




When to see a doctor


See your doctor if you've just started to have cluster headaches to rule out other disorders and to find the most effective treatment. Headache pain, even when severe, usually isn't the result of an underlying disease. But headaches can occasionally indicate a serious underlying medical condition, such as a brain tumor or rupture of a weakened blood vessel.


Additionally, if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different. Seek emergency care if you have any of these signs and symptoms:


An abrupt, severe headache, often like a thunderclap


A headache with a fever, nausea or vomiting, a stiff neck, mental confusion, seizures, numbness, or speaking difficulties, which can indicate a number of problems, including a stroke, meningitis, encephalitis or a brain tumor


A headache after a head injury, even if it's a minor fall or bump, especially if it worsens


A sudden, severe headache unlike any you've had


A headache that worsens over days and changes in pattern


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