I believe it was Todd who mentioned Northernlight.com as a

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Posted by Jack Boyd ( on January 18, 2000 at 18:24:12:

good source of medical info on clusters. I took a peek and the first info listed from their search engine is as follows, written by a Phd with a copyright of 9/99.
I thought some of it was right on and some of it was, well, you decide.....but I thought it was worth sharing.............

What is cluster headache?

Cluster headache is an excruciating pain around one eye and/or temple. The onset is rapid. It takes only minutes for a cluster headache to become extremely painful. The duration can be anywhere from fifteen minutes to several hours. Cluster headaches are usually more intense but shorter than other primary headaches, like migraine or tension headache. Cluster headache gets its name from the pattern of attacks. These headaches tend to occur in clusters. They may occur at the same time each day for weeks or even months, then disappear for prolonged periods. Sometimes they occur several times each day. Cluster headaches quite often occur at night or during sleep. The person is wakened by an intense pain in one side of the front of the head. During the cluster headache, the person is agitated and may even become violent. He will get up and pace, may even bang his head violently. He will remain restless until the headache goes away.

What are the symptoms of cluster headache?

Cluster headaches inflict extreme pain. The pain is localized around one eye and/or one temple. The pain is penetrating and sharp. Cluster headaches seem to run on some sort of internal clock. They typically occur about the same time or times of day. They may occur for several days, then have a brief interlude, and return with another cluster of days. Some people experience cluster headaches daily for a prolonged period of weeks or months. Then the headaches mysteriously vanish for weeks or months before returning. Some people have as many as six or eight headaches each day. Others have only one headache per day. Night is the most common time for cluster headaches. They wake the person from sleep. During the headache, the person becomes quite active and agitated. The eyes and nose also display changes. The pupil of the eye becomes smaller. The eyelid may droop down to partially cover the affected eye. The blink reflex may be inhibited.1 The eyelids and soft tissue around the eye may swell. The eyes may water. They may be bloodshot. The nose may run or feel congested. Symptoms come on very quickly. In a matter of minutes the person will have a full-blown, almost unbearable headache. A cluster headache is usually relatively brief. It lasts anywhere from a quarter of an hour to several hours. Within that range, shorter headaches are more common than longer ones. About half of headaches last an hour or less.2 Some people feel nauseated. The person may perspire. They sometimes avoid strong light and loud sounds.3 They may appear anxious or upset.

What are the causes of cluster headache?

The underlying causes of cluster headaches are not well understood. Originally considered vascular headaches, they are now considered to be neurological as well as vascular in origin. Cluster headaches involve dilation or widening of the blood vessels in the head during an acute attack. 4 The hypothalamic gray area appears to function abnormally during an attack.5 The hypothalamus controls endocrine and hormone production. It also controls the sympathetic nervous system. During an attack, the person is abnormally aroused. Sympathetic nerve activity in the muscles show twice the arousal during an attack.6 Blood vessels in the muscles constrict and raise blood pressure.7 The involvement of the hypothalamus and endocrine systems lead some to believe that there is a brain abnormality at the root of cluster headache.8 Serotonin, melatonin, and other neurotransmitters fluctuate abnormally during cluster headache.9 Adrenal hormones are also involved.10 The exact interaction of these substances is not yet known. Some believe that the immune system facilitates some of the symptoms of cluster headache.11 Cluster headaches are often triggered by alcohol, smoking, and stress. Sinus sensitivity can sometimes trigger cluster headaches. In that case, correcting the sinus problem can eliminate the headaches.12 There also seems to be a genetic component in cluster headaches for some people.13

How common is cluster headache?

Cluster headache is uncommon, especially among women. Men much more often get cluster headaches than women. As women more often work in stressful jobs, smoke, and drink, however, the number of women with cluster headaches is growing.14 Typically cluster headaches start in middle age or later. A person is more likely to get cluster headaches if one of his parents has cluster headaches.

What is the impact on people who have cluster headache?

Cluster headaches inflict extreme pain. They disrupt sleep patterns and leave the person chronically tired. If a person is having half a dozen headaches on a daily basis, he may be able to think about little else. Work and social life are completely disrupted. Even headaches limited to the evening will impair the ability to work effectively during the day.

Tests and diagnosis for cluster headache

Diagnosis of cluster headache relies largely on patient description of headache symptoms and frequency. The quality of the pain, the timing of the headaches, and the location of the pain typically differentiate cluster headaches from other sorts of headaches. The doctor may also want to run tests to eliminate other causes of head pain. Some vascular and sinus problems can mimic cluster headache pain. The patterned times of the headaches is a primary clue. Some migraines can be confused with cluster headaches. A careful description of symptoms can usually distinguish the two. Once in a while people get both sorts of headaches.

Prevention of cluster headache

The underlying cause of cluster headaches is not known. Current research indicates that there may be brain, nerve, and vascular abnormalities involved in creating cluster headaches. These cannot be avoided. Nonetheless, triggers of cluster headaches can be avoided. A person who gets cluster headaches should not drink alcohol, and especially not during a cluster period. Smoking is clearly associated with cluster headaches. The more the person smokes, the greater the relationship. Anyone with cluster headaches should not smoke. Stress also triggers cluster headaches. Reducing stress will reduce the incidence of cluster headaches. Learning ways to cope with unavoidable stress will also help.

-Report Written by Patricia Crowe, Ph.D. September 1999

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