Cluster headaches

Cluster headaches are brief episodes of often excruciating pain experienced in one part of the head. They occur in a characteristic pattern, usually between one and four times a day, and there may be gaps of months or years between each group of headaches. However, a few people have persistent cluster headaches that occur at regular intervals with very few remission periods between attacks. Like migraines, cluster headaches are likely to be related to an increase in blood flow as a result of widening of the vessels in the brain. These headaches affect about 1 in 100 people in the UK and tend to be more common in men. Smoking and drinking alcohol increase the risk.

What are the symptoms?

Cluster headaches often develop early in the morning. The major symptoms, which appear suddenly and affect one side of the head or face, include:


- Severe pain around one eye or temple.
- Watering and redness of the eye.
- Drooping of the eyelid.
- Stuffiness in the nostril and, sometimes, runny nose on one side.
- Flushing of one side of the face.

Individual episodes of pain may last from a few minutes to about 3 hours. The average attack lasts 15-30 minutes. If you have a sudden, severe headache for the first time or if you have symptoms that are different from those of previous headaches, you should consult your doctor at one so that a more serious underlying cause can be excluded.

What might be done?

Your doctor may prescribe an anti-migraine drug to help to reduce the length and severity of cluster attack. In a sudden, severe attack, oxygen inhaled through a mask may bring relief. If the attacks continue lithium and calcium channel blockers are sometimes effective.

If the cluster is prolonged, a short course of corticosteroids may help to prevent the headaches recurring. These drugs should be gradually reduced in dose, as advised by your doctor, as the headaches disappear.

If you are prone to cluster headaches, you should not smoke or drink even small amounts of alcohol because both increase the risk of an attack.

Cluster headaches may continue for the rest of your life, but you may have prolonged periods of remission.