Cluster headache



Background

  • M:F = 3:1, Early adulthood.
  • Cause unknown, may be familial.

Clinical

  • Unilateral headache onset on waking or early hours.
  • Sudden onset / offset, excruciating darting pain.
  • Short-lasting headaches (10 min - 2 hours).
  • No aura or neurological symptoms.
  • Nausea/vomiting are rare.
  • Accompanied by facial parasympathetic dysfunction.
    • Ipsilateral lacrimation / rhinorrhoea
    • Swollen eyelid/nose /face ± conjunctival injection.
    • Partial Horner's synd. may persist after the headache.

Differential Dx

Investigations

  • If MRI required (atypical presentation or persisting autonomic features), please ensure vasculature is also imaged (MRA MRV).

Management



Content By Dr Íomhar O' Sullivan date. Last review Dr ÍOS 16/09/19.