Hello. I don't know where I should post this so I am sorry. I am writing on behave of my boyfriend. He just turned 26.

He called me today to tell me about a headache he was having that started around 3pm. He told me that it was the worst one he has ever had by x50. He describes it as a huge pressure/explosion behind his left eye and it has spread his left temple as well. His eyelid is a little droopy and his nose is runny but he is getting over a cold and it is allergy season. He said his pupil is dilated as well. He said lights and bright noises make it worse. However, he can move his head without pain. He is still having the headache and it is now 4:40.

Does this sound like a cluster? This is his first time with this pain so there is no way to know if it happens at the same time everyday or if it is always on the same side and so on.

He needs to check in with a Headache Specialist for a proper diagnosis.

Hoppy

Could be a cluster, could be a brain aneurysm.  I'd probably head for the ER.

There are a surprising number of medical problems which mimic Cluster but which are not headache disorders.

He needs to see a doc who has skill/experience with headache. A large % of docs lack skill and training in this area of medicine. Best bet.....

LOCATING HEADACHE SPECIALIST

1. Yellow Pages phone book: look for "Headache Clinics" in the M.D. section and look under "neurologist" where some docs will list speciality areas of practice.

2.  Call your hospital/medical center. They often have an office to assist in finding a physician. You may have to ask for the social worker/patient advocate.

3. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE; On-line screen to find a physician.

4. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE Look for "Physician Finder" search box. They will send a list of M.D.s for your state.I suggest using this source for several reasons: first, we have read several messages from people who, even seeing neurologists, are unhappy with the quality of care and ATTITUDES they have encountered; second, the clinical director of the Jefferson (Philadelphia) Headache Clinic said, in late 1999, that upwards of 40%+ of U.S. doctors have poor training in treating headache and/or hold attitudes about headache ("hysterical female disorder") which block them from sympathetic and effective work with the patient; third, it's necessary to find a doctor who has experience, skill, and a set of attitudes which give hope of success. This is the best method I know of to find such a physician.

5. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE NEW certification program for "Headache Medicine" by the United Council for Neurologic Subspecialties, an independent, non-profit, professional medical organization.
        Since this is a new program, the initial listing is limited and so it should be checked each time you have an interest in locating a headache doctor.
=====================================================================
WHY A HEADACHE SPECIALIST IS RECOMMENDED


Headache. 2012 Jan;52(1):99-113.
Cluster headache in the United States of America: demographics, clinical characteristics, triggers, suicidality, and personal burden.
Rozen TD, Fishman RS.

THERE REMAINS A SIGNIFICANT DIAGNOSTIC DELAY FOR CLUSTER HEADACHE PATIENTS ON AVERAGE 5+ YEARS WITH ONLY 21% RECEIVING A CORRECT DIAGNOSIS AT TIME OF INITIAL PRESENTATION.