Cluster Headache

Overview

Cluster headache is a distinct and very painful primary headache. Attacks are severe, strictly one-sided (usually around the eye or temple), and last 15 minutes to 3 hours. They tend to occur in “clusters” — several attacks a day for weeks or months, followed by remission — and often follow a circadian pattern, striking at the same time each day, frequently at night. Although excruciating, cluster headache is not life-threatening; it is managed with specific acute and preventive treatments. For other severe headaches, see Severe Headache.

Symptoms

• Severe, one-sided pain in or around the eye, temple or forehead.
• Lasts 15 minutes to 3 hours; attacks recur up to several times a day.
• Restlessness and agitation during an attack (unlike migraine, where people lie still).
• Autonomic features on the same side: eye watering, red eye, drooping eyelid, nasal congestion or a runny nose.
• Often a predictable daily pattern, including night-time attacks.

Evaluation

Diagnosis is made from the characteristic history and examination. Because the symptoms are striking, a neurological examination and sometimes brain imaging are performed to exclude secondary causes, particularly when the pattern is atypical or the autonomic features are not classic.

Management

Cluster headache needs specific treatment. Acute attacks may respond to high-flow oxygen and injectable or nasal triptans — ordinary painkillers are usually too slow. Preventive treatment is started early in a cluster period to suppress attacks, and specialist input is often helpful. Avoiding alcohol during a cluster period is advised, as it commonly triggers attacks.

How we help

Dr. Nayak recognises the cluster pattern, excludes secondary causes, initiates appropriate acute and preventive treatment, and coordinates specialist referral where needed. Consultations are available in-clinic in Bhubaneswar and over teleconsultation.

Related conditions and patient concerns

• Severe Headache
• Migraine
• Headache
• Sleep-related Headache Concerns