Diagnostic Considerations

In addition to the conditions listed in the differential diagnosis, other problems than cluster headache (CH) to be considered include the following:

Acute hypertension (including response to pressors, pheochromocytoma, and preeclampsia)
Allergen exposure
Arteriovenous malformations
Brainstem syndromes
Cerebral venous thrombosis^[14]
Connective tissue disorder (eg, systemic lupus erythematosus)
Cyclical migraine
Eye disorders (eg, acute optic neuritis and acute glaucoma)
Hemicrania (continual or paroxysmal)
Ice-pick headaches
Intracranial neoplasm
Intracranial trauma
Interior carotid artery dissection
Intermittent hydrocephalus
Metastatic lung carcinoma
Nasopharyngeal carcinoma
Malignant and nonmalignant pain syndromes
Medication adverse effect
Pituitary tumors
Raeder paratrigeminal syndrome
Sleep apnea headache
SUNA (short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms)
SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing)
Vertebral artery aneurysm

Differential Diagnoses

Basilar Artery Thrombosis
Brainstem Gliomas
Cavernous Sinus Syndromes
Emergent Management of Subarachnoid Hemorrhage
Headache: Pediatric Perspective
Herpes Zoster
Intracranial Hemorrhage
Migraine Variants
Ophthalmologic Manifestations of Atopic Dermatitis
Pediatric Craniopharyngioma
Persistent Idiopathic Facial Pain
Pituitary Tumors
Postherpetic Neuralgia
Sinusitis (Rhinosinusitis) Imaging
Tolosa-Hunt Syndrome
Trigeminal Neuralgia

Workup

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Media Gallery

Cluster headache: Functional imaging shows activation of specific brain areas during pain. Courtesy of Wikipedia Commons.
Cluster headache (CH): Voxel-based morphometry (VBM) structural imaging shows specific brain area of CH patients' (hypothalamus) being different to non-CH patients' brains. Courtesy of Wikipedia Commons.
Non-rebreather oxygen mask with reservoir for the acute treatment of cluster headache. Courtesy of Wikipedia Commons.

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Author

Michelle Blanda, MD Chair Emeritus, Department of Emergency Medicine, Summa Health System Hospital; Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine

Michelle Blanda, MD is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Rima M Dafer, MD, MPH, FAHA Associate Professor, Department of Neurological Sciences, Rush Medical College of Rush University Medical Center

Rima M Dafer, MD, MPH, FAHA is a member of the following medical societies: American Academy of Neurology, American Headache Society, American Heart Association

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: AMGEN, ELI LILLY<br/>Received research grant from: ELI LILLY<br/>Received income in an amount equal to or greater than $250 from: AMGEN, ELI LILLY.

Chief Editor

Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM Adjunct Associate Professor of Neurology, University of Missouri-Columbia School of Medicine; Medical Director of St Mary's Stroke Program, SSM Neurosciences Institute, SSM Health

Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, American Headache Society

Disclosure: Nothing to disclose.

Acknowledgements

Joseph Carcione Jr, DO, MBA Consultant in Neurology and Medical Acupuncture, Medical Management and Organizational Consulting, Central Westchester Neuromuscular Care, PC; Medical Director, Oxford Health Plans

Joseph Carcione Jr, DO, MBA is a member of the following medical societies: American Academy of Neurology