Cluster headache

By Medically reviewed by hellodoktor


What is cluster headache?

Cluster headache is pain that occurs along one side of the head, often felt around the eye. The pain of a cluster headache is very severe, which is one of the most painful types of headache. Cluster headaches occur in recurrent “bouts” over several weeks (typically 4-12 weeks) followed by remission periods when the headaches stop.

How common is cluster headache?

Cluster headache is not common. It can be managed by reducing your risk factors. Cluster headaches are more common in men and tend to develop in people over the age of 20. Please discuss with your doctor for further information.


What are the symptoms of cluster headache?

The common symptoms of cluster headache are:

  • The pain is very severe and is often described as a sharp, burning or piercing sensation on one side of the head. It is generally situated in or around one eye, but may radiate to other areas of your face, head, neck and shoulders. Cluster headaches begin suddenly and without warning.
  • Feeling restless and agitated during an attack
  • A red and watering eye
  • Blocked or runny nose on the affected side
  • Sweaty face
  • Pale skin (pallor) or flushing on your face
  • Drooping and swelling of one eyelid

Cluster headache bouts separated by a remission period of one month or more are known as episodic cluster headaches. Chronic cluster headaches might continue for more than a year, or pain-free periods might last less than one month. During a cluster headache bout, the headaches often occur every day, sometimes several times a day and at the same time each day. A single attack can last from 15 minutes to three hours.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes cluster headache?

The specific cause of cluster headaches is unknown, but cluster headache patterns suggest that abnormalities in the body’s biological clock (hypothalamus) play a role. Many patients report their headaches begin while sleeping. Some possible triggers include alcohol, nitroglycerin. Hormonal factors, or menstruation, do not seem to trigger cluster headache.

Risk factors

What increases my risk for cluster headache?

There are many risk factors for cluster headache, such as:

  • Males are two to four times more likely to develop cluster headache than females
  • Most people who develop cluster headaches are over the age of 20, although the condition can develop at any age.
  • Many people who get cluster headache attacks are smokers.
  • Alcohol use. Alcohol can trigger an attack if you’re at risk of cluster headache. Many patients with cluster headache avoid alcohol during a cluster period.
  • A family history. Having a parent or family member who has had cluster headache might increase your risk of develop this disease.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.


How is cluster headache diagnosed?

Your doctor will ask about the history and charteristics of headaches and perform a physical examination.

The imaging tests, such as X-rays or MRI, may be recommended to rule out other serious causes of head pain, such as a tumor or aneurysm. In some cases, ophthalmologic evaluation is needed to exclude problems within the eye itself that may cause symptoms.


How is cluster headache treated?

The treatment of cluster headache can be divided into two categories: relief of the acute headache and prevention of future headaches.

Acute treatments:

  • Oxygen delivered a by face mask has been shown to help a majority of patients within a short period of time. Oxygen is generally safe and without side effects.
  • The injectable sumatriptan, which is commonly used to treat migraine, is also an effective treatment for acute cluster headache. Sumatriptan is contraindicated in patients with cardiac disease or untreated hypertension. Another triptan medication (zolmitriptan) can be taken in nasal spray or tablet form for relief of cluster headache.
  • Local anesthetics. Intranasal lidocaine has been suggested as a treatment option, but must be administered in a specific manner.
  • The injectable form of dihydroergotamine may be an effective pain reliever for some patient with cluster headache. This treatment cannot be used if a patient has used sumatriptan in the preceding 24 hours.

Preventive treatments:

  • Calcium channel blockers. Verapamil is often the first choice for preventing cluster headache.
  • Corticosteroids can be extremely effective to decrease a headache cycle. These can be used infrequently and for short-term use.
  • Lithium carbonate. Lithium carbonate may be effective in preventing chronic cluster headache if other medications haven’t prevented cluster headaches.
  • Melatonin might reduce the frequency of cluster headache.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage cluster headache?

The following lifestyles and home remedies might help you cope with cluster headache:

  • Stick to a regular sleep schedule. Cluster periods can begin when there are changes in your normal sleep schedule, so you should follow your usual sleep routine during a cluster period
  • Stop drinking alcohol. Alcohol consumption can trigger a headache during a cluster period.

If you have any questions, please consult with your doctor to better understand the best solution for you.



Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: June 16, 2017 | Last Modified: September 13, 2019