What is Cluster Headache?

Cluster headache is a neurological disease that is far less common than tension-type headache and migraine. However, it still occurs in 1 in 1,000 people in their lifetime, and 1 in 2,000 people in any given year. Cluster headache occurs more often in men than in women, with a 3:1 ratio. The headache is accompanied by prominent unilateral autonomic signs on the same side such as the headache, including tearing, conjunctival injection, ptosis, eyelid edema rhinorrhea as well as forehead and facial sweating.

In cluster headache the pain is located to the orbital, supraorbital, temporal temporal region, or in any combination of these sites. A key feature of cluster headache is that patients become restless during their attacks, which is an important feature distinguishing it from migraine. Cluster headache may be distinctly recognized for its pattern where attacks lasting for 1530 minutes to 3 hours and occurring up to 8 times daily can take place in clusters. These bouts may last for weeks or months at a time, and may occur seasonally. About 10% of people with cluster headache may have chronic cluster headache, where remissions between attack periods are not present or last less than 3 months annually. Patients with cluster headache may have triggers for their attacks such as alcohol, relaxing and when taking naps, but they evoke attacks only during a cluster period.

Cluster headache has genetic factors that are complex and not well-understood. Its pathophysiology may relate to activation of the hypothalamus, leading to repetitive activation of the trigemino-autonomic reflex via the superior salivatory nucleus in the brainstem and the sphenopalatine ganglion peripherally, the trigeminovascular system, and the release of inflammatory pain signaling neuropeptides such as calcitonin gene related peptide.

Our understanding of the anatomy and neurobiology of cluster headache has led to better therapeutic options for patients worldwide. There are numerous successful treatments for cluster headache, which means it is critical for clinicians worldwide to recognize what may the most physically painful disorder any human may experience.


The IHS Cluster Headache Awareness Campaign focuses on educating Healthcare Professionals, offering the essential information to assist them in managing patients with cluster headache.

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