Understanding Cluster Headaches: Symptoms, Triggers, and Relief

Consider These Triggers of Cluster Headaches: Common Causes

Cluster headaches may be caused by some of the various triggers discussed on these pages:

• Odors and fragrances

• Physical exertion

• High altitudes

• Barometric pressure (weather changes)

• Certain lights

• Hormones

• Medications

• Hormonal changes

These headaches differ from other headaches based on the physiologic changes that occur in the brain (involvement of the hypothalamus and trigeminal nerve), symptoms, and course. The reason why people develop these conditions is unknown, but in some cases, there is a genetic component, meaningit may be inherited.

Cluster headaches come on quickly without the prodrome or aura characteristics of migraines. They are often quite severe, sometimes called "suicide headaches" because they are so painful and often debilitating. These headaches manifest by one-sided head pain (sharp, burning, and constant) behind the eye and near the temple. They can be accompanied by redness and watering of the affected eye, swelling around the eye or lid, sometimes a droopy eyelid, a stuffy nose, pupillary changes, ear fullness on the affected side, and sometimes generalized sweating and redness of the skin, nausea and vomiting. Those who have cluster headaches often appear quite restless.

Attacks last from 15 minutes to 3 hours, and they can occur once or repeatedly over the course of a day. This can recur for weeks, months, and (rarely) years. Because an episode occurs in groups, it is called a  “cluster”  headache. Lying down often causes it to get worse.

Headaches

General Recommended Treatments and Lifestyle Adjustments:

Understanding cluster headaches: symptoms, triggers and relief.

• Avoid potential triggers if possible.​

• Pressure points

• Vagus nerve stimulation,

• Relaxation techniques

• Yoga

• Meditation/Mindfulness

  
  

​Herbal Remedies:

• lavender

• melatonin

• peppermint

Prescriptions

• Intranasal lidocaine

• Triptans (often used for migraines) (common: Imitrex comes in nasal, oral or injectable forms). Insurance can be finicky with these.

• Emgality ($$$) (Treatment and Prevention)

• Oral corticosteroids

• Prescription oxygen

  
  

​Prevention

• Verapamil

• DHE

• Lithium

• Emgality (Treatment and Prevention)

• Triptans

Understanding cluster headaches: symptoms, triggers, and relief is essential to wellbeing. If you cannot manage them or if you develop additional symptoms, as those listed below, it is important to see a healthcare provider.

When to See a Healthcare Provider

WARNING SIGNS

• A “thunderclap” headache – sudden severe onset - a "10 out of 10" - go to ER

• ​Do not dismiss frequent or severe headaches, especially if accompanied by

• Vomiting (especially projectile- a forceful outward-directed emesis )

• Double vision

• Change in your level of consciousness or change in behavior

• Recent head injury

• It is new and lasting for a few days (especially in the absence of a viral or bacterial infection)

• Is excruciating

• Has become  chronic/ongoing and does not respond to medicines

• If headaches especially occur after exercise_

• New onset of headaches after 50   (according to the American Headache Society)

• If you have more than one to two headaches a week or more than three to four per month 

• If you have less frequent headaches, but they are more severe and debilitating

• Your headaches start to feel different than your "usual" headaches