Cluster Headache

Question 1

Risk factors for cluster headaches

Answer 1

Male (3:1)
smokers

alcohol can trigger an attack

Question 2

Clinical features

Answer 2

• sharp, stabbing pain around one eye
• 1-2 episodes per day lasting 15 mins - 2 hours
• patient is restless/ agitated during an attack
• redness, lacrimation, lid swelling
• nasal stuffiness

Question 3

For how many weeks do cluster headaches usually last?

Answer 3

4-12 weeks

Question 4

Neuroimaging of choice in cluster headache

Answer 4

MRI with gadolinium contrast

(to also check for malignancy)

Question 5

Acute management of cluster headache

Answer 5

acute
- 100% oxygen
- Subcutaneous triptan

Question 6

Prophylactic management of cluster headache

Answer 6

verapamil = drug of choice

*some evidence to support a tapering dose of prednisolone