Cluster headaches are the most painful headaches. They are also called "suicide headaches" because unlike migraines, the pain attacks come so suddenly and with such big strength that you are literally helpless. The pain attacks can last a few minutes or up to three hours. After a pause they come again, often at the same time each day.
The pain occurs above or behind one eye and can also trigger additional symptoms like tearing, pupil changes or a droopy eyelid.
There is the theory that cluster headaches are caused be widened arteries which take too much blood and therefore put pressure on the trigeminal nerve.
The brain itself has no pain receptors but the blood vessels. It's unknown why the arteries start to dilate and how exactly this causes the pain.
Another theory with cluster headaches says that it also has something to do with the hypothalamus because the headaches often come at the same time. The hypothalamus regulates our biological clock.
While migraines and cluster headaches are both vascular headaches, they differ. Medications with are good for migraines have no effect on cluster headaches. Often you can feel migraines coming, especially when you also suffer from aura, some preceding neurological disorder which causes sight disturbance and tickling in arms and hands. Cluster headaches come without a sign of warning and with full force, very often during the night during the dreaming phase (REM).
Relaxation brings relief to migraines but makes cluster headaches worse. Moving around or performing a strong exercise brings some relief because it rushes fresh oxygen to the brain. This is also known as one of the fastest ways to fight cluster headaches. Inhaling pure oxygen right at the beginning of the pain attack can stop it within five minutes. The only other ways to battle the pain are direct injections with medications because medications taken orally are too slow.
Over-the-counter painkillers like Aspirin, Paracetamol and Ibuprofen work with migraines but not for cluster headaches. Here you need newer medications like fentanyl or steroids. Triptan drugs like sumatriptan and zolmitriptan also work. To prevent cluster headaches taking Magnesium has helped about 40% of the people.
Cluster headaches can disappear for weeks or months just to come back later with full force. It's the best to consult with an experienced neurologist to find the best treatment if you suffer from repeated and severe headaches. Cluster headaches can be more difficult to treat than migraines.
While a serious disease is not the reason for this type of headache and the headache itself is harmless, your doctor should exclude possible diseases with a CT scan and a blood test.
