A 31-year-old man presents to the emergency department complaining of recurrent extremely severe headaches. He denies any other past medical history and states there is no family history of headaches. He reports that he researched headaches online and thinks he may have cluster headaches.
Which of the descriptions are most consistent with cluster headache?
- A) Extreme facial pain that is very brief and is often triggered by light touch to the face.
- B) Headache that is bilateral, dull, and non-pulsating in a band-shaped distribution on the forehead and triggered by stress.
- C) Headache that is preceded by aura and includes photophobia and phonophobia.
- D) Headache that is consistently relieved by non-steroidal anti-inflammatory drugs (NSAIDs).
- E) Headache that is unilateral, recurs multiple times per day for a stretch of weeks, and wakes patient up from sleep.
E) Headache that is unilateral, recurs multiple times per day for a stretch of weeks, and wakes patient up from sleep
Cluster headache is often unilateral, recurs multiple times a day for a duration of a few weeks, is extremely painful, and can wake the patient up from sleep. It is more common in men than women. Oxygen therapy is the hallmark of treatment. Triptans such as sumatriptan are also effective in treating cluster headache. Answer A describes trigeminal neuralgia. Answer B describes tension headache. Answer C describes migraine headache. Answer D is nonspecific but NSAIDs can abort tension and migraine headaches.
Key Learning Point
Cluster headache is often unilateral, recurs multiple times per day for several weeks at a time, and may wake the patient from sleep.