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Although not quite CH specific, it really does illustrate the value of getting an MRI scan done when someone has significant headaches as you never know what the real cause of them will be until the appropriate investigation work has been completed.

Just a few years ago there was a brief run of journal articles supporting the routine use of scans as part of a diagnosic work-up for potential Cluster.

Such articles have disappeared of late. I only see a mention if there is/are concern that the headache issue is not classic Cluster

This is the only abstract that I've kept in view of this shift.
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J Headache Pain. 2008 Dec 16.
Functional magnetic resonance imaging in episodic cluster headache.

Morelli N, Pesaresi I, Cafforio G, Maluccio MR, Gori S, Di Salle F, Murri L.

University Centre for Adaptive Disorders and Headache (UCADH), Institute of Neurology, Department of Neurosciences, University of Pisa, Pisa, Italy, n.morelli@inwind.it.

We have investigated the cerebral activation centre in four patients with episodic cluster headache (CH) with functional magnetic resonance imaging (f-MRI). The patients underwent MRI scans for anatomical and functional data acquisition in the asymptomatic state, during a headache attack and after subcutaneous administration of sumatriptan. Anatomical images were acquired by means of 3D-MPRAGE sequences and f-MRI images were obtained by means of echo-planar imaging. Data was analysed using the BrainVoyager QX version 1.7.81 software package. IN ALL PATIENTS, THE DATA SHOWED SIGNIFICANT HYPOTHALAMIC ACTIVATION OF THE HYPOTHALAMUS IPSILATERAL TO THE PAIN SIDE, ATTRIBUTABLE TO A HEADACHE ATTACK. OVERALL, WE HAVE DEMONSTRATED THE ANATOMICAL LOCATION OF CENTRAL NERVOUS SYSTEM ACTIVATION BY MEANS THE FIRST F-MRI STUDY IN CH PATIENTS. f-MRI offers a good balance of spatial and temporal resolution, and this method of study appears appropriate for investigating the pathogenetic aspects of primary headaches. POSITRON EMISSION TOMOGRAPHY AND F-MRI MAY BE REGARDED AS LITTLE OR NO IMPORTANCE IN A CLINICAL CONTEXT, THEY DO, HOWEVER, OFFER GREAT POTENTIAL FOR THE EXPLORATION OF HEADACHE PHYSIOPATHOLOGY AND THE EFFECTS OF PHARMACOLOGICAL TREATMENT.

PMID: 19083151 [PubMed
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Grounds for scans appears to be limited to concerns when a cluster-LIKE situation is on the table. See:


Link to: cluster-LIKE headache:

IN: "Medications, Treatments, Therapies --> "Important Topics" --> "Cluster-LIKE headache"

Excellent link. I agree that it's a good idea to get an m_r_i just to rule out anything else such as hemorrhaging or a tumor or cyst on the brain.

However as I recall reading in the past, cluster headaches did not show anything on an m_r_i except for a little bit of extra grey matter when the hypothalamus is enlarged.

Somebody else more knowledgeable will hopefully contribute additional information regarding this very important subject.

Gregg in Las Vegas

Personal experience: colleague/customer with classic cluster symptoms.....mri or ct was done anyway.....it was a brain tumor....they operated almost immediately.....he's alive and fine today....things could have been real bad if correct treatment delayed because he "just" had ch...................

Best

Jon