Cluster Headache: Headaches Migraines

Content provided by the Faculty of the Harvard Medical School

Cluster headache

Cluster headache deserves special mention because, although rare, it is among the most painful of all headaches. A typical cluster headache begins suddenly, almost always at night, usually an hour or two after you fall asleep. The pain is intense, sharp, and penetrating, and it usually occurs behind one eye, which may be teary and bloodshot. The eyelid may droop, and the nostril on that side may first be stuffy and then runny. During a single attack, the symptoms will occur in either the left or right side, but never in both.

Unlike an individual with a migraine headache — who tends to lie quietly in bed — someone having a cluster headache attack is likely to pace the floor. The pain is so excruciating that it's tempting to bang your head against a wall. After an hour or two, the pain and other symptoms usually recede, sometimes just as suddenly as they came on. But they tend to recur at the same time day after day.

About 10 times as many men as women have cluster headaches. About 85% of those affected by this type of headache have the episodic form: clusters of one or two headaches a day over a period of two to six weeks, alternating with headache-free stretches. The remission time between cluster periods is generally 6–12 months, but it can be as short as a few weeks or as long as several years. The other 15% of those with cluster headaches have the chronic form. In these cases, the attacks continue for at least a year without any remission.

Last updated:	September 05, 2008