Cluster Headache

While migraine headache is far more common in women, cluster headache is more common in men. The term "cluster headache" is used to describe the clustering of short, painful, one-sided headache attacks. These attacks can occur many times during the day from weeks to months at a time, and then stop for a few weeks or months.

Cluster headache can be similar to migraine headache and can be unbearably painful. In fact, cluster headache sufferers often say that they feel suicidal due to the intense pain. Without proper diagnosis and treatment, cluster headache can last for years. Substances that dilate the blood vessels in the brain can trigger an attack. These substances include alcoholic beverages, nitroglycerin and histamines.

Cluster headaches (CH) are groups or “clusters” of short, extremely painful headache attacks. Most people with CH have “cluster periods” that are separated by headache-free periods called “remissions.” During a cluster period, you can have as many as eight headache attacks each day for weeks to months at a time. CH can be so unbearably painful that CH sufferers often report feeling suicidal due to the intense pain. Without proper diagnosis and treatment, CH can last for years.

SIGNS AND SYMPTOMS

A typical cluster headache attack is:

  • Severe or very severe – CH pain is very intense and may range from severe to unbearable. It may feel stabbing, burning, throbbing or constant.
  • One-sided – Most cluster headache attacks occur on only one side of your head. They can affect you in one or more of the following areas: inside your eye, above or around your eye, or on one side of your head or face. All headache attacks during a cluster period usually happen on the same side.
  • Frequent and occurs in clusters – During a cluster period, headaches can occur up to eight times each day.
  • 3 hours or less in length – Most cluster headache attacks last from 15 minutes to three hours. You can usually shorten the length of headaches by taking medicine.
  • Predictable – Although a typical headache attack begins quickly without warning, headaches often occur at about the same time of the day or night. They may be seasonal. Many people have headaches that occur every spring and/or every fall. For others, CH may begin within two weeks of the shortest and longest days of the year – December and June.

INJECTIONS AS A TREATMENT FOR CLUSTER HEADACHES:

Greater Occipital Nerve Block

There are two occipital nerves in the back of your head. Each nerve comes out of your upper neck and runs up to the top of your head. Each occipital nerve has two branches: a greater occipital nerve and a lesser occipital nerve. The greater occipital nerve supplies feeling to the skin on the back of your head and to the sides behind each ear. Your health care provider may suggest a greater occipital nerve injection, or “nerve block,” if other medicines fail to stop a cluster period. An injection may help to stop a cluster period and cause remission.

Your health care provider will give you an injection (shot) near the greater occipital nerve on the side of your headaches. The injection usually contains a steroid. It may also contain a numbing medicine called lidocaine. It may take a few days for your headaches to stop. If the nerve block works, it can result in remissions lasting from about one week to two and a half months.

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