Cluster headaches, often referred to as one of the most painful types of headaches, is a primary headache disorder characterized by recurrent, severe headaches on one side of the head, typically around the eye. Unlike other headache types, cluster headaches occur in cyclical patterns or clusters, which is where they get their name. Cluster headaches are sometimes said to be even more intense than migraines. As per research, it is seen three times more in men than women and the age group of 30s is commonly affected. The primary symptom of this neurological condition is severe discomfort that comes on and goes away, usually affecting one side of the head and the area surrounding the eye.

So what are the signs and symptoms one needs to watch out for? We got in touch with Dr Sahil Kohli, Principal Consultant, Neurology - Neurosciences, Max Hospital, Gurugram who shares signs, causes and management tips.

Signs And Symptoms Of Cluster Headaches

Dr Sahil Kohli shares that cluster headaches have distinct, sometimes severe symptoms, which include:

1. Severe Pain: Usually centred around one eye or one side of the head, the main symptom is unbearable pain that is frequently characterized as a burning or piercing sensation. Other parts of the face, head, neck, and shoulders may experience radiating discomfort.

2. Autonomic Symptoms: On the same side as the pain, these headaches frequently accompany autonomic symptoms such as teary, red eyes, drooping eyelashes, swelling surrounding the eye, Runny nose or congestion in the nose.

3. Restlessness: Those experiencing a cluster headache may find it impossible to sit still and may pace or rock back and forth.

4. Duration and Frequency: Cluster headaches usually follow a pattern. They can occur multiple times a day, lasting anything from fifteen minutes to three hours each time. The cluster period, which is characterized by recurrent episodes that can last for weeks to months, is followed by remission periods during which there are no headaches for months or even years.

Dr Sahil Kohli explains that although the exact cause of cluster headaches is not entirely understood, there are several identified triggers and contributing variables. These are a few typical triggers:

1. Smoking - Since it increases the frequency and intensity of attacks, smoking is a major risk factor for cluster headaches. The irritants in tobacco smoke may aggravate or cause headache episodes by causing inflammation and irritation of the sinuses and nasal passages. Numerous smokers who experience cluster headaches indicate a substantial correlation between smoking and the illness.

2. Bright Flashing Lights: A cluster headache may be caused by bright or flashing lights overstimulating the brain's pain pathways and visual cortex. Photophobia, or sensitivity to light, can make people with cluster headaches more vulnerable to abrupt or strong light sources.

3. Sleep Patterns: Cluster headaches may be brought on by modifications in sleep patterns, such as irregular sleep schedules or sleep apnea.

4. Food: Certain meals and drinks, such as those high in tyramine (old cheeses) or nitrates (processed meats), may act as triggers.

5. Strong Aromas: Headaches can be brought on by being around strong odours, such as paint fumes, gasoline, or perfumes.

6. Seasonal Changes: Cluster headaches tend to happen during certain seasons, which raises the possibility that variations in the amount of daylight, the temperature, or the barometric pressure could be factors.

7. High Altitude: Elevation changes, like flying or ascending a mountain, might act as a trigger.

Dr Sahil Kohli explains treatment for cluster headaches is complex and addresses both the immediate attack and the avoidance of subsequent occurrences.

- High-flow oxygen therapy, delivered through a non-rebreather mask at a rate of 7–15 litres per minute, can offer quick relief for acute bouts.

- Furthermore, drugs that constrict blood vessels and lower inflammation, like nasal spray zolmitriptan and injectable sumatriptan, are useful in lowering pain.

- A brief course of potent analgesics may be required in extreme situations. Calcium channel blockers, such as verapamil, are frequently the first line of treatment for averting further episodes and assisting in lowering the frequency and severity of headaches.

- During the first stage of treatment, brief courses of corticosteroids, such as prednisone, can also be used to interrupt the headache cycle.