Cluster headache

Cluster headache (CH) is a neurological disorder characterized by recurrent severe headaches on one side of the head, typically around the eye(s). There is often accompanying eye watering, nasal congestion, or swelling around the eye on the affected side. These symptoms typically last 15 minutes to 3 hours. Attacks often occur in clusters which typically last for weeks or months and occasionally more than a year.

The cause is unknown, but is most likely related to dysfunction of the posterior hypothalamus. Risk factors include a history of exposure to tobacco smoke and a family history of the condition. Exposures which may trigger attacks include alcohol, nitroglycerin, and histamine. They are a primary headache disorder of the trigeminal autonomic cephalalgias type. Diagnosis is based on symptoms.

Recommended management includes lifestyle adaptations such as avoiding potential triggers. Treatments for acute attacks include oxygen or a fast-acting triptan. Measures recommended to decrease the frequency of attacks include steroid injections, galcanezumab, civamide, verapamil, or oral glucocorticoids such as prednisone. Nerve stimulation or surgery may occasionally be used if other measures are not effective.

The condition affects about 0.1% of the general population at some point in their life and 0.05% in any given year. The condition usually first occurs between 20 and 40 years of age. Men are affected about four times more often than women. Cluster headaches are named for the occurrence of groups of headache attacks (clusters). They have also been referred to as "suicide headaches".