Cluster headaches tend to be very painful and occur in patterns of “clusters”. These headache clusters are episodes of headaches which occur with great frequency followed by latency periods where no headaches are experienced. These headache clusters may be unpredictable and can last for weeks or last for months, with intervening headache free periods of varying duration. Cluster headaches are often described as intense pain on one side occurring behind the eye and can be debilitating, though symptoms may occur more diffusely and with varying patterns.

The periodic nature of cluster headaches are a bit of a mystery, but it is clear that the occurrence of these headaches can be debilitating. Patients suffering from cluster headaches are not often able to predict when these clusters will come, and prolonged periods of headache suffering can cause significant impacts in patients’ lifestyles and activities of daily living.

FAQs: Cluster Headaches

  • Are there specific risk factors for cluster headaches?

    Cluster headaches seem to occur more often in men, and more often in smokers. There is some thought that the dilation of blood vessels may be related to cluster headache pain as certain vasodialator drugs such as nitroglycerine and histamine can cause attacks in some patients. It is this blood vessel dilation that may cause pressure on the peripheral nerves of the head and neck to trigger headache episodes. There also seems to be some genetic predisposition to these headaches as patterns within families have been seen.
  • What causes cluster headaches?

    While the cause of cluster headaches is not completely understood, the periodic nature of these headaches has indicated that they might be related to triggers in the hypothalamus which is a control center of the brain. It is this portion of the brain that controls circadian rhythms which help with sleep patterns. Special studies that look at metabolic activity in the brain have localized the hypothalamus as an area of enhanced activity during cluster headaches.
  • How are peripheral nerves related to cluster headaches?

    Alterations in the hypothalamus seem to have a relationship to changes seen in the trigeminal regions of the brain which control activity from the peripheral sensory nerves of the head and neck. These peripheral nerves that are addressed during headache surgery seem to have a role in the triggering of cluster headaches.
  • How can surgery help cluster headaches?

    While there does seem to be some periodic susceptibility to having a headaches in cluster headache patients, a secondary trigger seems to be additionally related to these episodes. In many patients the irritation of the peripheral nerves that are addressed during headache surgery can be a major trigger of headache pain. During the workup for headache surgery, these nerve triggers are identified through a series of specific nerve blocks which can indicate that a patient is a good candidate for headache surgery- one that can find relief from release or division of these affected nerves.

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