Patient education: Cluster headache (The Basics)

What is a cluster headache? — 

This is a headache that affects 1 side of the head. Cluster headaches can start quickly, happen frequently, and be extremely painful. They come with other symptoms, such as a droopy or watery eye, or a stuffy nose. These attacks happen repeatedly in groups, which is where the name "cluster" comes from.

Cluster headaches are more common in males and people who smoke. They sometimes run in families.

What does a cluster headache feel like? — 

A cluster headache usually involves attacks of:

●Severe pain in 1 part of the head – This can be around the eye or on the side of head. People often describe the pain as sharp or "stabbing."

●Other symptoms affecting 1 side of the head or face – These might include:

•A droopy or puffy eyelid

•A watery eye

•A small pupil (the black circle in the middle of the eye)

•A stuffy or runny nose

•Face sweating

During an attack, you might feel restless, pace, or rock back and forth.

An attack typically lasts between 15 minutes and 3 hours. Some people get repeated attacks over several weeks or months, followed by at least a few months with no attacks. Others have repeated attacks that continue for a year or longer.

Will I need tests? — 

Probably. Your doctor will do an exam and ask about your symptoms. They will probably also do an imaging test, such as an MRI or CT scan, to make sure something else is not causing your symptoms. These tests create pictures of the inside of your head.

How are cluster headaches treated? — 

Treatment options include:

●Oxygen – Breathing in 100 percent oxygen through a face mask can help stop the pain of a cluster headache.

●Prescription medicines – The ones most often used are called triptans. These can be given as a shot under the skin or as a nose spray.

If these treatments do not work or are not options for you, your doctor might suggest trying other medicines. The best treatment approach depends on your symptoms and your other health conditions.

What else can I do on my own? — 

If you smoke, try to quit. This might make your headaches less frequent. If you are having trouble quitting, your doctor or nurse can help.

Can cluster headaches be prevented? — 

Sometimes. If you get cluster headaches, your doctor might prescribe medicines or other treatments. This can help prevent attacks. Your options depends on how often you get attacks and how long they last. Your doctor might suggest:

●A medicine called verapamil (brand name: Verelan) – This is taken 2 or 3 times a day. Your doctor will talk to you about how and when to take it.

●Steroid medicines – These can be used in addition to or instead of verapamil. They are taken for a few days, and then the dose is decreased gradually.

Some people notice things that trigger their attacks, for example, alcohol or heat. It might help to avoid these things.

What else should I know? — 

Cluster headaches cause severe pain that can be hard to cope with. This can get in the way of your normal activities and make it hard to enjoy life. For many people, the attacks become less frequent with age.

Some people struggle with depression. If you are having trouble coping, talk to your doctor or nurse. They can suggest treatments that can help.

When should I call the doctor? — 

Call your doctor or nurse if:

●Your headaches start feeling different or get worse.

●Your headaches start happening more often.

●You have other symptoms with your headaches such as fever, weakness, or confusion.

●You feel sad or anxious, or are having trouble coping.

For some people, the pain gets so bad they have thoughts of suicide. If you are thinking about hurting or killing yourself, call for emergency help (in the US and Canada, call 9-1-1) or go to the emergency department. In the US, you can also call or text 988 to reach the Suicide & Crisis Lifeline.

More on this topic

Patient education: Headaches in adults (The Basics)
Patient education: Headaches in children (The Basics)
Patient education: Keeping track of your headaches (The Basics)
Patient education: Tension headache (The Basics)

Patient education: Headache causes and diagnosis in adults (Beyond the Basics)
Patient education: Headache treatment in adults (Beyond the Basics)
Patient education: Headache in children (Beyond the Basics)