Cluster Headache

Dr. Leopold is uniquely trained to treat cluster headache emergencies and offers mobile “house call” service for these emergency events (See “House Calls” tab on the home page).

Characteristics 

Cluster headaches (CH) are primary headaches classified under the group “trigeminal autonomic cephalalgias” (TACs). They are called cluster headaches because they occur in groups or “clusters”. The most common demographic affected by CH, are men between the ages of 20-50 years old. Cluster headaches can occur 8-10 times a day and typically last for about 5-15 minutes. This cluster “cycle” can go on for weeks or months at a time, followed by remission periods that can last for months, or even years. Cluster headaches are usually “one-sided” and considered the most painful of all headaches. Patients describe cluster headaches as a 10/10, “burning, stabbing, or excruciating” kind of pain, behind the eye on the headache side. Unlike migraine patients, cluster headache patients will become extremely agitated and will sometimes bang their heads against a wall or hard surface to distract themselves from the pain. During a cluster attack, symptoms on the side of the headache may include a red, tearing eye, runny/stuffy nostril, drooping eyelid, pupil constriction and sweating. These symptoms are known as Horner’s Syndrome.

Treatment:

Cluster headaches typically do not respond well to over the-counter pain medications to abort an emergency attack. Instead, clusters are relieved by injectable and intranasal Triptan drugs (Sumatriptan, zolmitriptan), intranasal Lidocaine, inhalation of pure oxygen, and opiates which are rarely used due to their habit-forming potential. Patients who frequently suffer from cluster headaches, should have a 100% pure oxygen cylinder/regulator in their home to use when they feel a cluster headache coming on. Breathing 100% pure oxygen for 15 minutes can help relieve the pain, so long as oxygen therapy is started before the headache reaches its peak. For preventative or prophylactic treatment of cluster headaches, medication therapies include anticonvulsants, calcium channel blockers, corticosteroids, ergotamine drugs, and melatonin.

Dr. Leopold looks forward to discussing all treatment options to find a pain management regimen
that suits your unique condition.