Approach Considerations

The diagnosis of cluster headache (CH) is based on historical and physical findings. A history of attacks that occur with the characteristic periodicity and rhythmicity is the key to the diagnosis. Laboratory studies are not of particular value in this regard.

Imaging studies, though not diagnostic, are useful for excluding other potential causes of headache in selected patients. Neuroimaging with assessment of the intracranial and cervical vasculature and the sellar and paranasal region is recommended in all patients with atypical presentations of trigeminal autonomic headaches.

Treatment & Management

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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