Cluster headaches is a distinct, although rare, clinical entity that occurs in 0.5% of the population. Attacks of headache occur several times a day in “clusters” for several days or weeks at a time. The headaches are shorter than a migraine, last from 15 to 30 minutes and up to 2 to 3 hours. The pain is usually severe, knife-like, unilateral and usually centered around the orbits or supraorbital area. Autonomic features such as conjunctival injection, lacrimation, nasal congestion, rhinorrhea, miosis, ptosis and eyelid edema are all part of the syndrome. Patients are then headache-free between clusters.
Unlike migraine, cluster headaches are predominantly a young male disorder beginning between ages 27 through 31, with a male to female ratio of 4 to 1.
Treatment of Cluster Headaches
Oxygen is the standard recommended treatment with 100% oxygen being administered at 7 to 10 liters/minute for approximately 15 minutes. Approximately 70% of patients will get some relief from their pain.
Subcutaneous Sumatriptan is the most effective medication for acute symptoms. The medication may have to be repeated with a second dose.
Prednisone given in large doses during an attack will help suppress headaches.