Cluster Headache

Cluster headache is among the most severe pain syndromes known. Attacks come in 'clusters' of frequent, intense, one-sided headaches lasting weeks to months, often with periods of remission.

Quick Facts

  • ICD-10: G44.0
  • Pattern: Episodic or chronic clusters
  • More common in: Men

Symptoms

  • Severe, often described as excruciating, one-sided pain — usually around the eye or temple
  • Attacks last 15 minutes to 3 hours
  • 1–8 attacks per day during a cluster
  • Restlessness or agitation during attacks (in contrast to migraine)
  • Associated features on the affected side: red eye, tearing, runny or stuffed nose, eyelid drooping, sweating
  • Often occur at the same time of day, including from sleep

Treatment

Acute attacks

  • 100% oxygen at 12–15 L/min via non-rebreather mask
  • Subcutaneous or nasal triptans

Preventive

  • Verapamil (most common)
  • Short courses of corticosteroids to break a cluster
  • Galcanezumab (CGRP antibody) for episodic cluster headache
  • Lithium for chronic forms
  • Occipital nerve blocks

When to See a Doctor

See a neurologist for severe recurrent one-sided headaches, especially with autonomic features. Headache patterns that change or new severe headaches should be evaluated.

Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.

References

  • American Headache Society. Cluster Headache Resources.