Cluster Headache
Cluster headache is a primary headache disorder causing short, extremely severe one-sided attacks around the eye in repeated bouts.
Key takeaways
- Tearing, nasal blockage, eyelid droop or facial sweating on the painful side and an urge to pace are characteristic clues.
- Oral painkillers usually act too slowly; high-flow oxygen or a rapid-acting triptan may be used under a confirmed plan.
- Preventive treatment is often started during a cluster period because attacks may recur several times daily.
The listings below do not establish cluster headache; a first or changed severe headache needs assessment to exclude secondary causes.
Recognising the pattern
Attacks typically last 15 minutes to three hours and recur at similar times over weeks, followed by remission in episodic disease. Migraine can also be one-sided but more often produces a desire to lie still. Brain imaging may be appropriate at diagnosis or with atypical features.
Acute and preventive roles
Subcutaneous or nasal triptan and correctly delivered high-flow oxygen are established acute approaches. Verapamil is a common preventive but requires ECG monitoring during dose adjustment. Corticosteroid or nerve block may provide temporary bridging while prevention begins.
When to seek urgent care
Call emergency services for a first sudden “worst” headache, new weakness or speech difficulty, confusion, seizure, fever with neck stiffness, eye pain with vision loss or headache after major injury.