Cluster Headache

Exam Cram

• Cluster Headache are severe 'suicide' headaches because they're associated with increased suicide rates

• Presentation severe, unilateral headaches with red tearing eye, lasts 30-60 mins, comes in clusters (3-4/day)

• Acute Management: 100% oxygen, paracetamol/ NSAIDs

• Prophylaxis- verapamil

Outline

Background

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Assessment

History

• Headache: unilateral, episodic 3-4/d lasting 30s, severe

• Concomitant nasal congestion

Examination

• Tearing/ red eye

• Nil focal neurology

• Observations normal

Investigations

• Normal (nil required usually

Diagnosis

Diagnostic criteria: clinical

Differentials (headache disorders): Tension Headache , Migraine , Medication Overuse Headache , Paroxysmal hemicrania

Management

Acute

• • High flow oxygen

  • Triptans may be of use in acute attacks

  • Card with diagnosis useful to give to patients to allow early oxygen for future attacks

  • Simple analgesia: paracetamol, NSAIDs

Long term (secondary prevention)

1. Verapamil

Med Reg Notes

Paroxysmal hemicrania

Occur more frequently during the day and are shorter than a cluster headache. 

Verapamil Regime

Start 40mg BD and titrate up

References and Resources

Page written in 2024.