I was reading this weekend about concussion.  It made me start thinking about my own situation.

Having suffered many concussions over my high school and college days, it makes me wonder if there is any correlation between the concussion and clusters. Concussion is basically a brain bruise.

Has anyone ever seen any articles on this topic. If so please let me know. 

Michael63 wrote on Apr 25^th, 2016 at 2:36pm:

I was reading this weekend about concussion.  It made me start thinking about my own situation. Having suffered many concussions over my high school and college days, it makes me wonder if there is any correlation between the concussion and clusters. Concussion is basically a brain bruise. Has anyone ever seen any articles on this topic. If so please let me know.

   

  If it were concussion related wouldn't there be whole boatloads of cluster heads?

           Potter

Neck injury's are known to cause severe headaches that can mimic CH's, but I doubt very much CH disease can be caused by concussion.

Hoppy

Having been concussed several times myself, and developing CH around the same time, I've long held the same suspicion and as you've brought up the subject I thought it time for some serious research.

Asked around my mates in the pub today and while more than half admitted to several concussions over time only one of them suffers an ongoing headache problem, which I know isn't CH.

Purely in the interest of science I'm going to a different pub tomorrow to carry out the same survey among a different mob of mates so I can compare results and submit it here for peer review.

Importantly I'm doing all this in my own time and at own expense because I reckon it was a fair question deserving an honest answer.

I had a bad concussion and a few weeks later started with CH. I strongly suspect that there is a link between the two. But proving it is non-trivial.

I had a couple of rather severe ones before developing CH....but they were years before so I have no clue if they were related.

Never been concussed.

Lots of CH's though.

Peter.

Just found this on the Cluster Headache Facebook page.

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Interesting to the point.

So the conclusion is.Those of us that are born with a dicky Hypothalamus is just waiting for something or another to trigger it off. In that case, all the headache types that mimic CH's are CH's, and therefor, theirs no such thing as CH disease.

Cheers, Hoppy

Hoppy wrote on Apr 26^th, 2016 at 8:06pm:

So the conclusion is.Those of us that are born with a dicky Hypothalamus is just waiting for something or another to trigger it off. In that case, all the headache types that mimic CH's are CH's, and therefor, theirs no such thing as CH disease. Cheers, Hoppy

Or concussion can cause CH...

Hey, this research lark is hard work, but it's important so I'll battle on.


Continued today by discussing it with the blokes at WoodDunny's Tavern and the results were quite similar. Around half have been concussed at some stage with one admitting to on-going headaches (CPH and well managed) along with our barmaid/bouncer who lives with classic migraine.

Arduous as this may be, I'm off to the Courthouse Hotel tomorrow to follow up on my research so far and will report accordingly, presuming I have the strength.

CDog wrote, Or concussion can cause CH...
CH disease are CH's, but as for the rest brought on by so called concussion, are mimics. Just my personal opinion.

hoppy

I have had several concussions, but all of them came after the onset of CH. Could it be, then, that concussions are caused by CH?

Cause and effect are very difficult to link based on anechdotal evidence.

JMHO
jlc

I'm the same as Peter. Plenty of CH but never been concussed.

Hey Brian, have a VB in the Couthouse for me and Len.  That was the most enjoyable CHI've ever had. ;D

Same here. Never been concussed.

Hoppy

My dedication continues and I now know why other researchers like Batch and MikeNZ are so well paid. It's remarkably hard work!

Certainly I'm collecting data but the hangovers are really quite something.

Today's efforts at the Courthouse Hotel yielded mixed results - some with concussion and no headaches and others vice versa. Remarkably few had both or neither. Not sure what to make of it so I'll have a drink and think.

Interestingly a lady visitor overheard the conversation (they're allowed in bars nowadays) and pulled me aside for a quiet yarn about her father. She described his headaches in graphic detail and there can be no doubt he was a CHead - every symptom and missing none - and she seemed genuinely relieved to finally understand because she always believed them to be real while others called him a bludger and a sook.

These are my findings so far, nothing to say concussion causes CH, and nothing to say it can't or hasn't. Not definitive, sure, but we always say there are no silly questions here at ch.com and I reckon everyone asking a question deserves an honest response.

And Maz, the pub is just as you left it except there's now a water feature in the beer garden where you got hit so badly and your Immi-pen refused to work. I must wonder what history would show today if it had been there at the time.

There was Dr. on this site some years back who did a survey on CH.  One of his findings was a strong correlation between CH and head trauma.

For CH, the incidence is around "124 per 100,000 people" (START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE) although the numbers vary with most sources quoting around 100 per 100,000 people.

For concussion I've not (after a few minutes of searching) found a solid figure, with the best I could do being "536 admissions per 100,000 people in a report that included emergency department visits, hospital discharge and coroner reports" (START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE). These figures are per year, so working off the US life expectancy of 78.8 years (START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE), this suggests a lifetime incidence of 78.8 x 536 per 100,000, i.e. 42,237 per 100,000.

This covers not just concussion but all traumatic brain injuries but note that if someone had a concussion, just saw a GP or similar and didn't go to hospital then they'd not be counted in these figures, so the actual incidence will be higher. But estimating how much higher will be complex and error prone.

So:

• CH - 1 per 1000 people (0.1%)
  
• head injury - 42 per 1000 people (4.2%)
  

Brian's reports show that many people he spoke to had had a head injury, so the 4.2% is most likely very much on the low side, but one could presume that if CH can result from a head injury then it is likely to be from a more severe head injury, so one involving a hospital admission or similar, so using the 4.2% figure is likely to be a reasonable estimate for the purposes of this study.

So if we take someone at random who has CH, then if there is no relationship between CH and head injury then there is likely to be a 4.2% chance that they will have had a head injury (very simplistic model as it does not take into account things like the figures include head injuries that killed the person, average age for CH onset and many other factors).

Looking at the number of people here on the forums (START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE), with 11,029 members and assuming that 10,000 have CH with the rest being supporters, this would suggest that around 420 people will have had a head injury too. Such people are more likely that most to respond to a topic like this too, so the incidence may appear to be even higher.

A study could be done looking at for those who have a head injury and doing a long term follow up to look at the incidence of CH. If there is no relationship then you'd expect to see about 0.1% of them have CH, but if there is a relationship then this would be significantly higher.

Assuming a connection, what we don't know is how quickly the CH would develop. Looking at parallel cases where NFL players and boxers develop brain issues, this seems to happen months to years after the injury. But for a CH link this may or may not be the case.

As to a mechanism for this to happen, CH has been shown to be strongly linked to the hypothalamus area of the brain. So since a head injury results in damage to the brain the potential mechanism could be that the head injury results in damage to the hypothalamus.

Looking on PubMed for research linking concussion and headaches (START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE) shows several hundred results, with 9 covering CH and concussion (START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE).

Of these, 4 are potentially applicable to CH:

• START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE - The headache may be nonspecific or mimic common nontraumatic headache disorders such as tension, migraine, and cluster.
  
• START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE - migraine- or cluster-like headache can be observed in rare cases
  
• START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE - This clustering of migraine symptoms supports the existence of PTM as a distinct clinical entity in some patients. [Not CH, but a strong parallel]
  
• START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE - The patients' medical history revealed a significantly high incidence of peptic ulcer disease and head injury with brain concussion. It is stressed that the side on which head injury took place is very frequently the same side on which cluster headache is located, although the latency between the two events appears to be a long one.
  

Now to turn all this from a hypothesis to a proven (or not) link will take a lot of work in accurately modelling what the expected results should be (i.e. not using my very simplistic model) and then doing a large scale followup on people with head injuries to determine their incidence of CH.

The last of the 4 links above covers a study looking at patients with CH to review their medical history and from the wording it implies a statistically significant linkage between the two.

So on the basis of the current research, there is possibly a link between them.

AussieBrian wrote on Apr 28^th, 2016 at 2:10am:

Interestingly a lady visitor overheard the conversation (they're allowed in bars nowadays) and pulled me aside for a quiet yarn about her father. She described his headaches in graphic detail and there can be no doubt he was a CHead - every symptom and missing none - and she seemed genuinely relieved to finally understand because she always believed them to be real while others called him a bludger and a sook.

Good work Brian on reassuring this lady about her father.

Now to translate for people from a different corner of the world:

• bludger - an idle or lazy person
  
• sook - a person lacking spirit or self-confidence.
  

I had a number of sports concussions in my late teens and early 20s. That was 30 years ago however I have wondered on many ocasions if there could possibly be some residual issue from concussion that may have led to the development of my CHs.

Stay Positive

Con

I had a concussion and head injury at the age of 20 after being hit head on by a drunk driver. My Ch's started 2 years later. I've often wondered about the correlation, but there's just no way to prove it. My Ch's occur on the same side as my head trauma though so it does make me suspicious that there is some kind of link. It's also worth noting that my mother suffered from severe headaches, but what kind remains a mystery because she's passed on. I've read a couple articles that also suggest a genetic component, though I'm not exactly sure what the numbers are to support this theory.

The bottom line is that the research is insufficient and there's no way to really say definitively one way or the other. Many diseases can be caused or triggered by multiple sources, so who's to say that the same doesn't apply to CH?  A great example of this is a dear friend who has lung cancer. She has never smoked a day in her life. Who knows? Strange things happen sometimes.

Mish C. wrote on May 22^nd, 2016 at 7:45pm:

I've read a couple articles that also suggest a genetic component, though I'm not exactly sure what the numbers are to support this theory.

One paper on this subject...

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J Med Genet 1995;32:954-956 doi:10.1136/jmg.32.12.954
Cluster headache is an autosomal dominantly inherited disorder in some families: a complex segregation analysis.

M B Russell, P G Andersson, L L Thomsen, L Iselius


Quote:

We investigated the mode of inheritance of cluster headache in 370 families. The probands were from a neurological clinic in Jutland and two departments of neurology in Copenhagen County, Denmark. The criteria of the International Headache Society were used. The patterns of segregation of cluster headache were assessed by complex segregation analysis performed with the computer program POINTER. Of the 370 probands with cluster headache, 25 had 36 relatives with cluster headache. The segregation analysis suggests that cluster headache has an autosomal dominant gene (p < 0.10) with a penetrance of 0.30-0.34 in males and 0.17-0.21 in females. The gene is present in 3 to 4% of males and 7 to 10% of females with cluster headache. An autosomal dominant gene has a role in cluster headache in some families.

When I saw a specialist, Dr Fink if I remember correctly,  I asked about concussions and cluster headaches.

He said that it's quite possible, and even likely, that concussions affect how cluster headache symptoms are expressed, but he had not seen anything to indicate that they can cause them outright.

Hi AubanBird . . . glad you're back and especially pain free . . . hope you have a long spell before next deployment.


  OK, had to chime in on this one.  I've reported over the years that my attacks started after a head trauma (1/01).  After coming here 2/02) and getting the info/support/materials which allowed me to work with the doc and have some control . . .at least once I saw the figure 16-20% of CHers suspected head trauma as possible cause.   If that's not correct I've been passing on bad info, BUT . . .

. . . .when I hit my head, the attacks started  within days . . . two weeks at the most.  Doc ordered CT . .nothing . . at my insistence it HAD to be related (area of the hit), did another CT and MRI . . .normal (of course)

  I reference the area because the pain (eye first of course) radiated to upper sinuses to the impact point and of course the lower sinuses and the 9s 10s the teeth.

  Was a stupid self-injury which brought much laughter from my companions.  We were hauling fishing gear back to the truck and had to navigate under a 4" steel pipe, attempting to not step in the puddle of water naturally formed by frequent traffic along that trail.  At almost a jog. I tried to sidestep the puddle while ducking under the pipe  . . .  didn't duck low enough . . .  hit the pipe right above my eye, 2" over my eyebrow in a head down (45 degrees) position.

  Perhaps it's not just head trauma, but area of head trauma and direction of impact.  For example, an acupuncture needle can stimulate one system in a certain position, but move it an inch in a different direction and it will stimulate a totally different system/area of the body.

  I am obviously convinced MY CH started with head trauma . . .  will stop using the 16-20% number til' confirmed/disproved . . . . and will start asking the question:  If you had head trauma, what area of head and direction of impact?

  Would like to hear more on this.

   
     Be Safe,

        PFDANs,

          Richard

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Thanks for the link Hoppy,

But I was only able to glean a small bit of info as the audio wasn't working.

Could it be that the top of the spine could be transferring some compression on the hypothalmus in an injury such as mine??

   Richard

Hi Richard,
I think it would be worthwhile discussing this further with your Doctor/Neuro/Headache Specialist.

Hoppy

36 years ago on a rainy Fall night at age 11, I suffered a severe closed head injury causing concussion. Within weeks I began my first cycle of CH's, that became "normal" to suffer every other year, on odd numbered years, in the Fall, Left side.

Brain specialists, neurosurgeons, neurologists, headache specialists all concluded the concussion created the onset of my CH's. Back then they prescribed Sansert, a med now banned in the USA.

Every other year in the Fall on odd numbered years most of my life, I would turn into the Incredible Hulk or Jekyll and Hyde or Werewolf transition or whatever Hell you refer CH's. It was clockwork, hence the hypothalamus gland. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

Some very sophisticated tests revealed a Dopamine imbalance. More info on CH's & Dopamine here - START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE and START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

In 1999 I found this website and began my obsession to learn of my haunting disease to the point I was able to comfortably educate neurologists.

If it wasn't for this website, I would have commit suicide. Not even a 2nd thought about it. But instead, I found a wonderful support group who became "family" and they helped educate me, so that I could further educate the ignorant doctors, who then could better help me during my cycles.

Unfortunately many of those "family members" here in Clusterville do not frequent this site anymore. Ever since OUCH went away, and Clusterbusters became very popular, this site has lost its strength. But make no mistake, if you are new to this site, there is more here to learn than any other resource worldwide, and there is always somebody sincere that is willing to help.

In 2006, I had another severe closed head injury. This time I went into a coma. My cycles have been far and few between since. Instead of every other year on odd years, I have skipped two cycles. The past 10 years i've only had 2 cycles, normally 5. Perhaps there is correlation between head trauma and CH's, perhaps it is coincidence and I am part of the "aging theory."

My conclusion is that head trauma likely brought on my CH's and head trauma likely reduced the frequency of my cycles.

Well, there's my brief story, hope it provided a bit of insight.

-Gregg in Las Vegas