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Cluster Headaches

What are cluster headaches?

A cluster headache is an uncommon type of headache that can cause sudden extreme pain on one side of the head, usually around or behind an eye. The headaches typically occur at the same time every day for several weeks and then do not occur for a few months. They may occur at night after you have fallen asleep. The period of time when you are having the headaches is called a cluster period.

How do they occur?

The cause of cluster headaches is not known. They happen in men more often than women. They do not seem to be caused by disease and they do not run in families like some other types of headaches.


Cluster headaches may be triggered by:

  • alcohol
  • tobacco products, such as cigarettes
  • stress
  • bright or glaring lights
  • lack of sleep.

Keeping a headache diary may help to show a pattern for when the headaches are occurring. It may teach you about possible triggers and help you to avoid them

What are the symptoms?

Intense pain on one side of the head is the main symptom. The headache hurts the most about 5 to 10 minutes after it begins.


Other symptoms that may occur with cluster headaches are:

  • pain in one eye and sometimes a red eye
  • a stuffy or runny nose on the painful side of the head
  • watery eyes or tearing, usually on one side
  • red, flushed face
  • sweatiness
  • restlessness.

How are they diagnosed?

Your healthcare provider will ask about the history of your symptoms and examine you. It will help if you keep a record of:

  • when you have the headaches
  • what part of your head is affected
  • how bad the pain is and how long it lasts
  • other symptoms you have at the same time.

Your provider will also want to know what medicines you are taking and about your use of alcohol and tobacco.


You may have tests, such as CT or MRI scans, to rule out other serious causes of the headaches.

How are they treated?

Your provider may prescribe medicine that you can take to prevent cluster headaches. You may take it every day of the year or only during a cluster period to reduce the severity and number of headaches. Two medicines commonly used to prevent the cluster headaches are the calcium channel blocker verapamil and lithium carbonate.


Another medicine, such as sumatriptan, may be prescribed to relieve the pain when a headache occurs. It is important to take this medicine as soon as the headache begins. The medicine needs to be fast acting because the pain of a cluster headache becomes severe very quickly. For this reason, your provider may prescribe this medicine as a shot or in a form that can be inhaled through the nose.


Nonprescription medicines such as aspirin, ibuprofen, or acetaminophen usually do not help because they do not work fast enough. It is important to try to treat the pain before it becomes severe.


Breathing pure oxygen through a mask may also help relieve pain.

How long do the effects last?

The headaches usually last 30 to 90 minutes. The pain usually ends as suddenly as it begins. The headaches may come back daily for weeks or months, then disappear for months or years. Most people have 1 to 2 cluster periods a year.

How can I take care of myself?

During a cluster period:

  • Take medicine prescribed by your provider exactly as directed.
  • Try to remain calm. Do not change your usual routine.
  • Do not change your sleep patterns. Especially avoid taking afternoon naps, which seem to bring on the headaches in many people.
  • Do not drink alcohol.
  • Do not smoke.

The recurrent and intense pain of cluster headaches can make you depressed or anxious. You may find that talking with a counselor will help you cope with the effects of cluster headaches. Sometimes joining a headache support group can help.


For pain in or around an eye that does not go away, see your healthcare provider to make sure that there is not a problem with the eye.

How can I help prevent cluster headaches?

Your healthcare provider can prescribe medicine, such as verapamil or lithium, that will reduce the number and severity of headaches you have during a cluster period.


It may also help to:

  • Figure out what seems to trigger your headaches and avoid those things.
  • Learn how to manage or reduce stress.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.


HIA File neur3405.htm Release 13/2010

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