Cluster Headache

Excerpt

Cluster headaches are the most common of the primary headache type known as trigeminal autonomic cephalgias (TACs). They are relatively rare, plaguing 0.1% of the population, making studying the disease process difficult at best. They have earned consideration as one of if not the most severe types of headache, and so, despite their rarity, recognition and treatment are vital. There is some degree of genetic correspondence, as first-degree family members are 18 times more likely to be diagnosed with cluster headaches. However, the mode of inheritance is unclear. Some families seem to pass the symptoms along with an autosomal recessive pattern, while others seem to be autosomal dominant.

Like other trigeminal autonomic cephalgias (TACs), cluster headache is a short-lasting unilateral headache with at least one autonomic symptom ipsilateral to the headache, such as lacrimation, nasal congestion, conjunctival injection, or aural fullness. The associated nasal congestion can sometimes lead to a misdiagnosis of "sinus headache," and patients are often managed by decongestants, which are ineffective for cluster headaches. These headaches can occur every other day to eight times a day. They usually occur at approximately the same time of day, most often at night. Most patients are episodic, with daily attacks for weeks to months, followed by remission for months to years.