All of us have experienced a headache in some or the other time in our life. If mild, we tend to ignore it, however, if severe then it tends to interfere in carrying out our daily activities. People may experience different kinds of headaches- in the front above the eyes or at the back of the head or on left or right side of the head or the whole head. Basically, headaches are two types. Primary headaches occur independently and not caused by any medical condition. Secondary headaches occur due to medical conditions elsewhere in the body.
When you have headache, various parts of your head may get hurt which include nerves that extend over your scalp, nerves in the face, mouth and throat, muscles present in the head and blood vessels present along the surface and at the base of the brain and these contain fragile nerve fibers. The tissue of the brain and bones do not contain nerve fibers and as such cannot be hurt. These pain sensitive nerves can be stimulated by stress, tension in muscles, dilated blood vessels and other headache triggers. Less than 0.5% of the population suffers from cluster headaches and 80% of all the cases are men.
Headache in clusters
As the name suggests, cluster headache is a type of headache that occurs in cyclical pattern or clusters of frequent attacks. The time period for which a cluster of frequent attack lasts is called the cluster period. Cluster headaches are extremely painful, and come about the same time every day for upto 12 weeks or till the cluster period is over. Cluster headache starts suddenly, usually on one side of the face, and generally behind or around one eye. The nose and eye of the same side may become inflamed or swollen accompanied by excessive tearing. It usually lasts for 45 to 90 minutes, and may happen for one to three times a day. Cluster headache can occur during day or night, and the nocturnal bouts are more excruciating than the day time attacks.
Cluster headache is also termed as suicide headache as many people took their lives during the bout or in its anticipation. Once the cluster period is over, remission follows during which the headaches disappear for weeks, months and sometimes for years.
Causes of cluster headaches
Cluster headaches are not related to other disorders or illnesses, and the real cause is not known. However, cluster headache seems to get affected by certain triggers which seem to activate the chief facial sensory nerve. This nerve, also termed as trigeminal nerve, is responsible for sending sensory inputs from the face to the brain. Therefore, in cluster headaches the symptoms may mostly associate with the face like pain in the eye, tearing of the eye, swelling, redness, and inflammation of the nose.
Hypothalamus, a portion of the brain that causes production of hormones that control body temperature, hunger, moods, sleep, thirst, release of hormones and body’s biological clock also is thought to play an important role in cluster headaches, because the symptoms of cluster headaches occur cyclically.
Other factors include medications such as nitroglycerine, heavy smoking and alcohol consumption, sleep interruption, abnormal levels of hormones such as melatonin and cortisol, and abnormal levels of neurotransmitters (chemicals) such as serotonin may play important role for the development of cluster headaches.
Available treatments for cluster headaches
There are various treatments available for the treatment of cluster headaches. You need to consult your doctor for the right course of treatment suitable for you and schedule the convenient regimen.
Cluster headaches can be prevented by inhaling pure oxygen. But as the bouts of cluster headaches happen suddenly, it may not be practical to know when cluster headaches are about to start and opt for inhalation of oxygen.
Your doctor may recommend two courses of medicines to be taken during the cluster period. The first medicine is to be taken regularly so that a high level of drug is always maintained in your blood, and the incidence of the number of headaches is minimized. The second medicine is given to relieve the pain when the bouts start, and you need to take these medicines as soon as the headaches start as the medicine is to treat the pain. You may have to keep your family members informed of the situation so that they can help you when the cluster headaches occur.
Oral medicines take time to affect; your doctor may prescribe an injection or spray or as a rectal suppository. Medicines to be taken under tongue may also be prescribed for faster absorption. Your doctor may prescribe a local anesthetic in the nose to relieve you of the pain.
Managing cluster headaches
Even though cluster headaches are very painful, they can be successfully managed through proper help. You need to work with your doctor for the preventive medicines you can take during cluster headaches to reduce the incidence and also the severity. Once the cluster period has started it is of utmost importance to keep up the regular routine, avoid being agitated, and avoid changing the sleep patterns as it might trigger the bouts of cluster headaches. Avoid triggers such as alcohol, smoking, and caffeine.