Approximately 45 million Americans suffer from some type of chronic headache. More than one million of these people suffer from the rarest and most severe type of headache, cluster headaches, 90% of those who sufferer cluster headaches are male aged 20-50. Smoking and alcohol use can increase your risk of getting a cluster headache and family history also increases your risk.
A cluster headache, characterized by intense pain concentrated on one side of the head and around the eye, is a chronic, very painful type of headache that occurs in cycles called clusters (hence the name). These clusters may last for days, weeks, or even months at a time followed by a headache free period that may last weeks, months, or even years before they return.
What are the symptoms of cluster headaches?
Sufferers say the pain of a cluster headache is sharp, very intense, burning pain, often described as a hot poker in the eye. Other symptoms of the cluster headache includes
- Severe, intense pain, on one side of the head, around one eye, and the face, neck and shoulders.
- Lacrimation (tearing of the eyes)
- Red, puffy eye on the side of the pain
- Droopy eyelid
- Pale, sweaty skin of the face
- Affected sinus on the side of the headache. It may be runny or stuffy, or both alternating.
- Restlessness and irritability
- Sensitivity to light
- Seeing an “aura” around objects
When these headaches strike the person will experience a headache that lasts from 15 minutes to several hours intermittently several times throughout the day. They usually occur at the same time each day and usually occur at night after having been asleep for 2-3 hours. The headache usually starts suddenly and ends abruptly.
How are cluster headaches diagnosed?
Diagnosis begins with discussing your symptoms with your doctor. You may undergo neurological examination and will undergo MRI (magnetic resonance imaging) and CT scan
(computerized tomography) in order for the doctor to get images of the vessels of your brain as well as the brain itself to determine if a tumor or restricted vessel is the cause of your headaches.
How are cluster headaches treated?
Due to the rapid onset and sudden cessation of cluster headaches sometimes it is difficult to treat them. One treatment is 02 (oxygen) therapy where the patient will breathe 100% oxygen for about 15 minutes to relieve their headache. This is effective but only applicable in the home as the oxygen bottle is inconvenient to pack around everywhere. Triptans like sumatriptan (Imitrex), or zolmitriptan (Zomig), can provide relief and are available in injectable form or fast acting nasal sprays. However the most effective treatments for cluster headaches are steroid and botox injections. Steroid injections in the form of occipital and suboccipital nerve blocks provide quick but short term relief that is intended to break the cycle of the headaches and so reduce the frequency of the clusters. Botox injections work by blocking the pain signals to the brain and thus relieving the pain and other symptoms that occur with the cluster headache.
What are expectations when a patient receives injections?
These injections are very successful in providing relief to cluster headache sufferers. The majority of cluster headache sufferers report as high as 80% success rate in relieving some or all of their symptoms.
How is the injection performed?
These are intranasal injections, (inside the nasal passage), and so the patient will be sedated and their vital signs monitored. A long thin needle is inserted through the sinus passage with the aid of a fluoroscope, (a type of x-ray machine), in order for the doctor to access a nerve cluster behind the sinus cavity. The medications are injected through the cavity wall and bathe this nerve cluster effectively numbing it. This stops the pain signals to the brain and so relieve pain.
How long do the benefits of the injections last?
Many patients experience immediate relief from the local anesthetic used but this is temporary and wears off in about 24 hours. However the other medications will soon take effect and then the relief is of much longer duration. The benefit from these injections are long lasting, many patients experience relief for several months at a time.
What risk or side effects are possible with these injections?
This is a minimally invasive procedure and side effects and risks are low. Swelling and bleeding is possible and there is a remote possibility of infection. Ironically temporary headache is possible with the injection but it is much less severe than the cluster headaches being treated and will subside as the medications take effect.
How successful are they for the relief of pain?
These procedures are very effective for relieving patients’ pain and other symptoms associated with their cluster headaches and the majority of patients’ report significant reduction in pain levels. The top metro Chicago pain management clinics, Premier Pain & Spine, offers comprehensive headache treatments. This includes both medication management and interventional treatments at seven locations. Most insurance is accepted. Call (847) 519 4701 for more information and scheduling with pain management Chicago trusts!
Sleep apnea in patients with cluster headache: A case-control study.
[Therapy of trigeminal autonomic headaches].
[Genetics of primary headache syndromes].
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