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Cluster Headache: Signs, Symptoms, Causes, Risk Factors, Triggering Factors, Diagnosis, Preventions and Treatments

Cluster Headache: Signs, Symptoms, Causes, Risk Factors, Triggering Factors, Diagnosis, Preventions and Treatments

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Published by Kyle J. Norton
Cluster Headache also known as suicide headache, is defined as an uncommon distinctive neurovascular syndrome occurring in either episodic or chronic patterns of that occur periodically over a long period of time. The diseases affects over 0.1% of the population, occurring at 45-to 60-day intervals with one to three headaches a day lasting 45 min to 2 h(a), if untreated it, can cause increased frequency of the attacks.
Cluster Headache also known as suicide headache, is defined as an uncommon distinctive neurovascular syndrome occurring in either episodic or chronic patterns of that occur periodically over a long period of time. The diseases affects over 0.1% of the population, occurring at 45-to 60-day intervals with one to three headaches a day lasting 45 min to 2 h(a), if untreated it, can cause increased frequency of the attacks.

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Published by: Kyle J. Norton on May 08, 2012
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09/06/2013

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Primary Headaches - Cluster Headache: Signs,Symptoms, Causes, Risk Factors, TriggeringFactors, Diagnosis, Preventions and Treatments
ByKyle J. Norton
Please note that all articles written by Kyle. J. Norton are for information andeducation only, please consult with your doctor or related field specialist before applying.
I. Cluster Headache
Cluster Headache also known as suicide headache is defined as anuncommon distinctive neurovascular syndrome occurring in either episodicor chronic patterns of that occur periodically over a long period of time. Thediseases affects over 0.1% of the population, occurring at 45-to 60-dayintervals with one to three headaches a day lasting 45 min to 2 h(a), if untreated it, can cause increased frequency of the attacks.
II. Signs and Symptoms1. Pain
Pain is more intensify compared with other types of headache
.
Dr. Peter Goadsby, Professor of Clinical Neurology at University College London,commented: "Cluster headache is probably the worst pain that humansexperience. I know that’s quite a strong remark to make, but if you ask acluster headache patient if they’ve had a worse experience, they’lluniversally say they haven't. Women with cluster headache will tell you thatan attack is worse than giving birth"(b)
2. Anxiety and depression
Researchers suggested that Cluster headache (CH) patients who weredepressed or anxious were more likely to present at a younger age and haveattack-related nausea and prodromal symptoms. Depressed CH patients werealso more likely to have another pain disorder and had undertaken twice asmany prophylactic medication trials(1)
3. Unilateral headaches and extreme intensity
 
In the study conducted by Mayo Clinic College of Medicine, cluster headache attacks are stereotypical, that is, of extreme intensity, of shortduration, occurring unilaterally, and associated with robust signs andsymptoms of autonomic dysfunction. Unlike migraine, during an attack the patient with cluster headache often paces about. Attacks frequently occur atnight, awakening the patient from sleep(2)
4. Sense and behaviour of restlessness
In the study of comprised 86 consecutive new cluster headache patients (68males, 18 females; mean age, 38.4±12.2 years; range, 17-73 years). result
 
showed a relatively low prevalence of chronic cluster headaches, anduncoupling of a sense of restlessness and restless behaviour(5)
5. Tearing and Rhinorrhea
Tearing and Rhinorrhea are trigeminal-autonomic headache symptoms as aresult of symptoms of autonomic dysfunction, occurred during the attacks of cluster headache(7)
6. Facial and eye pain
Facial and eye pain are associated with the autonomic innervation of the eyeand orbit asa result of cluster headache debilitating conditions.(12)
7. Facial pain
In a study by Dr. Oomen KP and the tead suggested that correct headacheand facial pain diagnosis is vital to assess the outcome of different treatmentstrategies. Even in a tertiary center, headache and facial pain can bemisdiagnosed. RFT of the SPG may be effective in patients with facial pain(8)
8. Other symptoms also include the following
a. Ipsilateral conjunctival injection and/or lacrimation b. Ipsilateral nasal congestion and/or rhinorrhoeac. Ipsilateral eyelid oedemad. Ipsilateral forehead and facial sweatinge. Ipsilateral miosis and/or ptosisf. A sense of restlessness or agitation(9)
 
8. Etc.
Although most cluster headache patients are experiences certain symptomsof autonomic dysfunction as the connection of cluster headache (CH) attackswith rapid eye movement (REM) sleep has been suggested by variousstudies, in some patients Cluster headache attacks are found no associationof CH with REM or sleep disordered breathing was observed. Increasedheart rate temporally associated with transition from one sleep state toanother was observed before patients awoke with headache. Total sleeptime, total wake time, arousal index and distribution of non-REM sleepstages were different between chronic and episodic CH(4). Other studyshowed that patients with cranial autonomic symptoms (CAS)wereexperience no pain in CH attacks, whereas another five patients continued toexperience typical cluster headaches(6)
III. Risk factors1. Gene
In the review of only genetic studies with limited sample sizes have been performed, but results have indicated an association with the HCRTR2 gene,which is involved in the regulation of chronobiological rhythms(c). Other suggested that cluster headache has an autosomal dominant gene with a penetrance of 0.30 to 0.34 in males and 0.17 to 0.21 in females. The gene is present in 3% to 4% of males and 7% to 10% of females with cluster headache(f)
2. Gender
Men are at higher risk than women in development of cluster headache(d)
3. Family history
In the study of California Medical Clinic For Headache, found that threegenerations of cluster headache were found in 7/24 kindreds (29.17%).Parental cluster headache was found in 19 of the 24 probands (79.17%); in14/19 (73.68%), transmission was from father to proband. fifty percent of cluster probands also had migraine headaches, and almost 50% had a familyhistory of migraine. Similarly, of the larger population of 300 cluster  patients, approximately 45% had a positive family history of migraine. f 1652 relatives of all cluster patients, 3.45% had cluster headache (thirteentimes the expected frequency of cluster headache in the general population)and 17.55% had migraine headaches(g)

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