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Cluster headache

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Headache, Cluster - Cluster headache, also known as histamine headache, is a specific vascular headache syndrome. Attacks usually are severe and unilateral and typically are located at the temple and periorbital region. Each headache is brief in duration, typically lasting a few moments to 2 hours. Cluster refers to a grouping of headaches, usually over a period of several weeks.

At one time or another, almost everyone has had a headache. Some headaches are only moderately painful, while others are severe and disabling. No matter what kind of headache you have, you'd rather be without it.

In most cases headache pain, even severe headache pain, is not the result of any underlying disease. In fact, the vast majority of headaches are primary headaches - headaches that aren't caused by a specific medical condition. These include migraines, tension-type headaches and cluster headaches.

Cluster headaches - which involve a stabbing pain on one side of the head - are relatively rare, affecting less than 1 percent of people. Eighty-five percent of those affected by cluster headaches are men. Cluster headaches are much less common than migraines, but the pain is considerably worse.

Although a cluster headache can be temporarily debilitating, it causes no permanent harm. The condition doesn't cause complications or lead to other disorders. Treatments can't stop you from getting cluster headaches, but they can help decrease the severity of pain and shorten the duration of the headache.

Signs and symptoms

Cluster headaches generally produce signs and symptoms on one side of your head. The signs and symptoms may include:

  • Intense burning or penetrating pain, often described as a stabbing or hot poker sensation, in or around one eye or temple, occasionally radiating to your forehead, nose, cheek, or upper gum and jaw

  • Bloodshot or teary eye

  • Blocked or runny nostril

  • Reduced size (contraction) of pupil

  • Drooping or swollen eyelid

  • Flushed face

  • Excessive sweating

Cluster headaches occur rapidly. The pain typically intensifies within 5 to 10 minutes to a peak that usually lasts from 30 minutes to 3 hours. Cluster headaches often occur 2 to 3 hours after you fall asleep, usually during the phase of sleep characterized by rapid eye movement (REM). They may awaken you at night or in the early morning. However, they may occur at any time. Often they occur repeatedly at the same time of day.

Cluster headaches can occur daily for days, weeks or months before remission occurs. Remission may last weeks or years between attacks. Cluster headaches often occur in groups or clusters of attacks (episodic attacks). Cluster headaches can also occur at any time unexpectedly (chronic attacks) for as long as a year or more without remission. A chronic phase may begin after a period of episodic attacks.


Although the cause is unknown, research suggests that abnormal activity in the part of the brain called the hypothalamus may be the source of cluster headaches. The hypothalamus controls body functions such as eating, sleeping and sexual behavior, maintains body temperature and chemical balance, and regulates many hormones. The hypothalamus appears to be active during a cluster headache attack on the side of your head in which the pain occurs.

Risk factors

Unlike migraines, which more often affect women, cluster headaches predominantly affect men. Eighty-five percent of people affected by cluster headaches are men between the ages of 20 and 50. Many people who get cluster headaches are heavy smokers. Alcohol can trigger an attack if you're at risk of cluster headaches. Usually there's no family history of cluster headaches.

Cluster headache > 1 > 2 > 3 > 4

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