General Practice 2022

Cluster headache: what é, symptoms, causes and treatment

Table of contents:

Cluster headache: what é, symptoms, causes and treatment
Cluster headache: what é, symptoms, causes and treatment
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Cluster headache is a very uncomfortable situation and is characterized by intense headache, which arises in attacks, and which happens only on one side, with pain behind and around the eye on the same side as pain, runny nose and inability to do any other activity as the pain is quite severe.

Cluster headache has no cure, however the treatment indicated by the neurologist aims to relieve symptoms and reduce the frequency of attacks, and it may be necessary to use some medications such as non-steroidal anti-inflammatory drugs, opioids and, in some cases, use of an oxygen mask.

Symptoms of cluster headache

The symptoms of cluster headache are quite uncomfortable, and the person may have episodes of intense headache 2 to 3 times a day for about 15 to 20 days. In addition, it is common for at least one of these episodes to happen during the night, usually 1 to 2 hours after falling asleep. Other signs and symptoms that are usually indicative of cluster headache are:

  • Throbbing pain only on one side of the head;
  • Red and watery eye on the same side as the headache;
  • Pain behind and around the eye;
  • Swelling of the face on the side of pain;
  • Difficulty fully opening the eye on the side of pain;
  • Runry nose;
  • Headache that lasts between 15 minutes and 3 hours, most commonly lasting up to 40 minutes;
  • Inability to perform any activity due to severe headache;
  • Pain is not influenced by light or food;
  • Discomfort in the affected region after decreasing pain.

It is not known when the crisis will end, but some people report that the headaches start to be more spaced, with fewer episodes per day, until it disappears completely, only returning months or years later. Also, it's not possible to know what might trigger a new crisis after months apart.

Thus, the doctor can make the diagnosis of cluster headache by observing the symptoms presented by the person, and magnetic resonance imaging may also be recommended, for example, to check for any brain changes. In the absence of changes, the person is usually considered to have cluster headaches. However, the diagnosis is time consuming and is made by the neurologist after months or years, so it is common for not all patients to be diagnosed in their first cluster headache attack.

Main causes

In most patients, stress and fatigue are related to the onset of crises, but there is no scientific proof of this fact. The age at which this type of migraine begins to manifest is between 20 and 40 years, and although the cause is unknown, most patients are men.

The causes of cluster headache are believed to be related to the malfunction of the hypothalamus, because it seems to be related to the circadian cycle, which regulates the time of sleep and wakefulness, but despite this, its cure has not yet been found and its causes are not fully known.

How the treatment is done

The treatment for cluster headaches should be guided by the neurologist and aims to reduce the intensity of pain and make the crisis last for a shorter time. Thus, the physician may indicate the use of non-steroidal anti-inflammatory drugs, triptans, ergotamine, opioids and the use of a 100% oxygen mask in times of crisis.

As seizures are more common at night, a good tip is for the individual to have an oxygen bag at home when a crisis period begins. Thus, the pains decrease considerably making it more bearable. Taking 10 mg of melatonin before bed can also relieve symptoms and lower the risk of a flare-up.

Furthermore, the patient cannot drink any alcoholic beverages or smoke because these can trigger an episode of headache immediately. However, outside the crisis period, a person can consume alcoholic beverages socially because they will not trigger a new crisis period.

Possible side effects

Despite the benefits that they bring in pain relief, medications prescribed for cluster headaches can have as side effects nausea, dizziness, feeling of weakness, redness in the face, heat in the head, numbness and tingling in the body, for example.

However, the use of oxygen masks for 15 to 20 minutes, with the patient sitting and leaning forward, provides rapid pain relief in 5 to 10 minutes and has no side effects when the patient does not have associated respiratory diseases.

Common pain relievers like Paracetamol have no effect on pain relief, but soaking your feet in a bucket of hot water and placing ice packs on your face can be a good home solution because it reduces the caliber of the vessels blood vessels, being very useful in combating pain.

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