I see sinus infections as the opposite of a nerve block - it is inflammation and nerve activation that feeds into the trigeminal and can push a person towards CH. It is not the prime cause but can be a contributing cause in many people.

If you get the sinus infection cleared up, it might help with the clusters, or it might not. But it is worth dealing with for its own sake.

I disagree with your opinion, Bob. When the sinuses, jaw or other areas near the trigeminal nerve are injured or inflamed, it means more nerve traffic (including possible referred pain) to the trigeminal. This can aggravate the trigeminal and make it more susceptible to cluster activity. 

My 5 year remission was broken last year a few days after I choked and ended up vomiting through my nose. This occurred in late winter, and all previous attacks I have had were always in summer. The injury that pushed me from a long remission to a cycle was to the sinuses, not to the hypothalamus.

You are right that correlation is not always causation, but it can be, and you have not refuted the dozens of world class cluster researchers that believe that there is often a causal relationship between injury or inflammation to a wide variety of structures in the head - the sinuses, endonasal contact points, carotid artery dissection, pituitary tumors, etc etc.  None of these is 'The cause' but all can be part of the cause for some people.

In this 10 year study on surgery of endonasal contact points for clusters, a 65% success rate was found. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

The study "Trigeminal autonomic cephalgias due to structural lesions: a review of 31 cases" found that clusters, SUNCT and paroxysmal hemicrania were not only frequently associated with various anatomical problems, but that treating the structural abnormalities typically resulted in significant immediate and sustained clinical improvement. That is evidence that it is more than an accidental correlation, but is tied into a causal relationship.

In general, clusterheads have something strange and pathological going on with blood flow around the sinuses:  Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

Treating a sinus infection may not always break a cycle or provide some relief - the problems may be deeper than the infection that the doctor notices. Depending on the patient, the common forms of sinus surgery may or may not help. But it is wrong to say that science has determined that the sinuses are never a factor, or that treating a sinus condition cannot help. 

I just recently had a cat scan for my brain and also for sinus area.  My brain came back completely healthy but they found out I had a bad sinus infection.  My particular doctor told me that sinus infections very well indeed can start a cluster cycle and is convinced that is what started mine.  As a matter of fact, a sinus infection started my cycle two years ago and around the same time of the year.  For my body, I just know they are directly related.  I've been on antibiotics for about 5 days and my clusters have slowed down their frequency and intesity and I getting excited that my cycle might be getting close to being over!

Hi Dax,
I know this post is over 6 months old, but I was searching the site looking to see if anyone else thought that maybe there was a relationship between CH and Sinus infections.  That seems to be the case with me also, but, as I look into the past, I see a pattern which has to be CH.  I always assumed that it was a sinus thing because I would always have sinus probs at that time.  The thing is, I'v never heard of a normal sinus sufferer discribe the kind of pain that we endure.  I was wondering if maybe there is anything new that you have learned since this post.?  God bless you, and I hope you are feeling great!  Thanks.....
Matt

My current cycle (after a 3+ year remission) started in mid-October, about a week into a nasty sinus infection.  A round of antibiotics cleared up the infection but I'm still in-cycle.

Did the infection trigger the cycle?  Possibly but most likely coincidence.

Here is some food for thought though:  I started having CH about 15 years ago--after having...sinus surgery. 

Coincidence?  Most likely.  In fact, a year or so after the surgery I went back to the ENT because I was having "sinus headaches."  After X-rays showed my sinuses to be clear, the doc started asking some questions about the pain.  After hearing my answers he asked if I had ever been diagnosed with CH.  He called my PCP and told him to send me to a neurologist.

The neuro put me on Zoloft 50mg and after a month moved me up to 100mg.  The attacks stopped after a couple more weeks and all was fine until the next fall and it all started up again.  This time the neuro added verapamil 120mg and upped it to 240mg after a while.  Same result, after a couple of weeks the cycle ended.

She took me off both Zoloft and verapamil and all was fine for another year.  By this time the neuro had moved on and I saw a new one.  This one tried Topamax, upping the dose until she decided it wasn't working.  She then switched to verapamil and still no change.  Only after adding Zoloft back to the mix did the cycle break.

Another year off the meds and the annual fall ritual was underway.  This time my PCP went straight to Zoloft and it knocked the cycle out within a month (they are usually 3-4 months).

All was well for a couple of years then another cycle started.  I was already taking Zoloft and went to see yet another neuro, who added verapamil 240mg.  The cycle broke again in about a month or so and I was happy.

This sort of thing has continued since then--a few years of cycles followed by 1 to 3 years off-cycle.

Sorry, sort of got to rambling there.  Anyway, I don't really think the sinus surgery had anything to do with my initial bout with CH but the recent sinus infection may have been just enough at just the right time to help trigger this cycle (which seems to be winding down now).

EDIT:  One thing I forgot to mention is that I get nasty nosebleeds when in-cycle.  Another coincidence?  Probably.

Back in the day they always thought i just had a bad sinus infection but in reality its just the c.h.s ,the c.h.s make the sinus cavities inflamed and such. Just misdiagnosis through and through,try the suma shots

Most docs for me just called it sinus infection because they had no idea what i had,in the past a lot of docs though it was sinus infection ,but in reality it could be just CHs,my nose either runs or gets stuffy through my clusters and shadows.Thats a common symptom

One Love

The V.A.