Cluster headache causes and consequences. Causes and treatment of cluster headaches

Cluster headaches are considered to be one of the most severe types of headaches. This type of pain is characterized by such a frequency and intensity of pain that there have even been cases of suicide at the time of attacks.

Cluster headache is characterized by a series of attacks of high intensity. These seizures are also called clusters, hence the term originated. The headache can occur several times a day and last from a couple of minutes to an hour. Attacks can be exhausting for a long period of time - from 2-3 days to several weeks or even months, and then disappear without a trace and not disturb for years.

Symptoms

Cluster headaches are easily recognizable and are distinguished by the following features:

• Attacks make themselves felt in the age range from 20 to 50 years;
• The pains come on suddenly, there are no signs of an approaching attack;
• As a rule, the attack begins late at night;
• The pain is accompanied by nasal congestion, watery eyes, and ear pain;
• Cluster headache usually has a concentrated lesion, usually around the eye;
• Most often, pain attacks are attacked in the autumn or spring months;
• The attacks are repeated at the same time of day, while the focus of pain does not change;
• Vision deteriorates, there is swelling of the eyelids and damage to the eye capillaries;
• Blood rushes to the face sharply, sweating appears;
• The heartbeat becomes rapid.

Causes of occurrence

Why cluster headaches occur is not exactly established. Studies show that men suffer from this type of headache 6 times more often than women. Heavy smoking and alcohol consumption is thought to increase cluster headache attacks, but this is nothing more than theory. It is also believed that the appearance of pain of this type is due to a genetic predisposition, but this feature is not inherited.

Treatment

Treatment for cluster headaches is usually symptomatic and does not get rid of them permanently. Strong pain relievers are gradually addictive and need to be changed periodically.
Traditional medicine has its own remedies to help relieve cluster headache attacks.

Cayenne pepper

This spice contains a substance called capsaicin, which gives the pepper a hot spice. Capsaicin is irritating and can be found in some pain relievers. Ointments based on this substance must be rubbed into the temples when headache attacks appear, this will help to relieve pain

Turmeric

This seasoning is distinguished by its soothing and anti-inflammatory properties. Turmeric works well for tolerating cluster headaches and is not addictive, so you can use it regularly.

Kudzu

The plant is known as lobular kudzu. In Russia, little is known about its medicinal properties, but in traditional Chinese medicine, kudzu is included in the list of 50 medicinal herbs. Helps relieve dizziness, headaches, ear congestion and prevent poisoning.

Ginkgo

A well-known herb that improves blood circulation, ensuring its flow to the brain and beneficially affecting the condition of the blood vessels. These properties help relieve headaches of any intensity. Unfortunately, only "live", unprocessed ginkgo leaves, which are quite difficult to get, have a healing effect. Plant-based syrups, tablets and supplements are highly questionable.

Nuts are extremely rich in nutrients, thanks to which they are an excellent antioxidant. In addition, walnuts have a beneficial effect on blood circulation, improve blood composition, calm the nervous system and strengthen the immune system.

Although a cure has not yet been found that will make you forget about cluster headaches forever, you should make sure that they appear as rarely as possible. It is recommended to give up alcohol and cigarettes, exercise in moderation, be outdoors more often and adjust the diet.

In addition, it is useful to protect yourself as much as possible from stress and, if possible, find time for proper sleep.

Cluster headache is characterized by strong painful sensations, this is due to the fact that pain occurs in the places of contact of the brain tissue with the skull.

Usually such an attack comes on unexpectedly with very severe pain. Sometimes the pain can be unbearable and can cause rash actions to relieve the attack.

General information

Headaches in this situation occur serially. Maybe several attacks in one day and this can last for months or even years. The duration of an attack is several minutes, and can reach several hours.

A side effect can be eye pain or ear congestion. The eyes turn red, watery, the nose clogs up, the blood rushes to the face, there is increased sweating.

Such manifestations are observed in one part of the face, and can spread to the entire face. Sometimes such manifestations are associated with a change in the season. Aggravation occurs in spring or autumn.

Science has not yet identified why such attacks of cluster headache occur and why such manifestations can be inherited.

Signs of a cluster headache

• cluster headaches begin to appear after the age of twenty;
• an attack occurs without any prior symptoms;
• it is impossible to predict the moment of onset of pain;
• the pain is very severe;
• the frequency of attacks is different;
• during the day there can be about ten attacks, the average number is about three;
• the time of the onset of the attack may be repeated;
• at the end of a certain period of painful attacks, there may be remission for several years;
• men suffer from such attacks six times more than women;
• most often, pain is observed on one side of the face, but in fifteen percent it can spread to its entire area;
• nighttime attacks of headache are possible, which will be repeated and occur in the same way as the previous ones;
• eyes redden, watery, nasal congestion and increased sweating are felt;
• the eyelids are swollen and may fall down;
• there is a temporary deterioration in vision, the pupil decreases;
• pulse quickens;
• the main periods of manifestation are observed in autumn and spring;
• the use of alcoholic beverages, even in small doses, can provoke an attack of cluster headache.

Cluster headache attacks are distinguished from migraine attacks. It should be noted that in the study of this disease, scientists have identified some patterns.

Mostly such attacks affect men of tall stature, strong constitution and with large facial features. It was also revealed that they all have light eye color and are heavy smokers. They start smoking quite early and drink alcohol the same way.

But these are only observations, and the reason for this manifestation has not been established, why men of the same type and with similar habits are prone to such attacks. No causal relationship has been established.

Why do headache attacks appear?

It is generally accepted that this is a certain disorder in the body, which is associated with biorhythms. This judgment is based on the fact that each person's body has its own biorhythms.

Cluster seizures have their own frequency, which is directly related to cycles in nature. They usually repeat with great precision and at the same time of day and season.

Human biorhythms are designed to regulate enzymatic activity, body temperature, affect the secretion organs and many other functions of the body. When cluster headaches appear, we can talk about disruptions in the work of biorhythms.

Perhaps this is influenced by the disruption of the hypothalamus, which regulates daytime biorhythms. The process can occur in this order - the hypothalamus, by means of impulses, affects the central nervous and circulatory systems, as a result of which vasodilation occurs, which leads to the appearance of cluster headaches.

Maybe their appearance is influenced by the level of serotonin, which has a connection with histamine and affects human biorhythms. This process in the body can affect the sensation in the eye area. Histamine levels affect the dilation of blood vessels. With histamine injections, headaches can occur, so they put forward this version of headaches.

Many people complain that headaches occur during sleep. Scientists have found that this occurs during REM sleep. There is no scientific basis for the effect of alcohol as a provoking factor.

By itself, alcohol dilates blood vessels, which can cause headache attacks. Therefore, it is not recommended for patients prone to cluster headaches, even in small quantities.

Treatment of headache attacks

Severe headache attacks are very difficult to treat. An oxygen mask is often used to relieve an attack and relieve pain. Perhaps physical education and sports will help get rid of cluster headaches. But the load during classes and their frequency must be agreed with a specialist.

As one of the ways to relieve headaches, nasal drops containing somatostanin or lidocaine are used, but such drugs can only be used under medical supervision.

Cluster headache is also called in medicine. The pain during an attack can be very intense. Such manifestations do not need to be tolerated, consult a doctor and follow his instructions.

First of all, you need to take an anesthetic drug, after which the attack subsides and it will be possible to establish its root cause. In some cases, it is recommended that you make notes in the form of a diary, where you need to note the frequency of attacks and how you feel during them. This measure is very helpful in diagnostics.

Usually the doctor prescribes:

• preparations with ergotamine and caffeine;
• procedures using pure oxygen, it must be inhaled;
• to relieve acute pain, nasal drops with lidocaine;
• drugs of the triptan group.

For the prevention of such attacks, the following are prescribed:

• verapamil hydrochloride;
• lithium carbonate;
• various antiepileptic drugs.

Doctors all over the world are unanimous in the opinion that alcohol and tobacco can provoke cluster headaches. If you quit these bad habits, remission can occur without treatment.

What triggers cluster headache attacks?

• tobacco;
• alcohol;
• narcotic substances;
• stress;
• depression;
• overwork;
• food products containing food additives and preservatives;
• increased body temperature.

The frequency of attacks and the strength of pain will depend on this. At home, you can relieve headache attacks, or at least reduce their frequency.

To do this, you can use:

• high concentration oxygen, inhale for twenty minutes;
• take medications only as directed by a doctor;
• if necessary, take additional medications to eliminate side effects;
• keep a diary.

With cluster headache, it is necessary to choose the right method and method for relieving seizures. This process can take a certain period of time until you find the most effective method for your body. Try using folk remedies or herbs as a supplement to enhance the effect of drugs. But in such a situation, it is imperative to consult with your attending physician about their compatibility.

Such attacks are recognized as one of the most difficult and painful. The attack can last for a very long time and therefore it is necessary to learn how to get rid of it correctly.

Cluster headaches can be a deterrent to achieving your life goals. Drugs can become addictive and the desired effect will not be achieved. There are several foods you can try that will affect your headache attacks.

Cayenne pepper is used to make various ointments and pain relievers. If you rub such an ointment into the temporal region, you can reduce pain and the attack will gradually go away.

Turmeric has a sedative effect and can be used in food without restriction.

Kudzu will help to cope with dizziness, headaches, even relieve ear congestion. It is used as a preventive measure against poisoning.

Ginkgo improves overall circulation, but only in its raw form.

Walnuts are an established antioxidant. With their help, immunity increases, blood composition and blood circulation improve. But they can be consumed no more than two, three pieces every other day.

Your behavior can be a good cure for seizure reduction - try to avoid stressful situations and not overwork. The modern rhythm of life and constantly arising everyday problems are a very common factor in the appearance of cluster headaches.

Cluster headache can be difficult to treat. Therefore, if a specialist has made such a diagnosis for you, you need to pay great attention to preventive measures.

• daily regime;
• healthy sleep;
• walks in the open air;
• healthy food;
• physical education and sports.

These well-known rules should become your constant companions. Be very careful about drinking strong tea or coffee. Moreover, if you are prone to high blood pressure.

Sports activities should take place under the supervision of a specialist or at least after consultation with him. In modern gyms, you can create an individual training program and gradually increase it. For these purposes, there is a trainer or instructor in them. Such activities can be useful at any age.

A very wide range is presented among medicinal herbs, but it is also necessary to use them according to a certain dosage, taking breaks so that addiction does not occur.

Decoctions and herbal tinctures can be used by mouth or for compress. You can combine several herbs or take only one, there are a lot of options.

Summarizing

Cluster headaches are rightfully recognized as one of the most problematic in their classification. With frequent and severe attacks, you must immediately consult a doctor, undergo an examination in order to find out the root cause of their appearance.

When undergoing a course of treatment, strictly follow all the doctor's prescriptions and consult with him on any matter that interests you.

The use of herbal medicine and traditional methods of treating headaches is widespread. The correct approach to such methods brings positive results.

They are used both as preventive measures and the main course, it all depends on the strength and frequency of attacks. It is allowed to combine several methods, only by agreement with the doctor.

When working with hazardous substances, be sure to use personal protective equipment, use fermented milk and other products in food that can remove them from the body.

Any chronic or serious illness can cause attacks of cluster pain, so a special course of treatment is necessary. Even in the modern pace of life, do not forget about rest and walks in the fresh air.

The human body is designed so that it can withstand certain loads and overloads. But if this continues constantly, he can begin to malfunction any of his systems, which can lead to complex diseases and, as side effects - headache attacks, they will be frequent and severe.

Try to choose the most effective method of treatment and a set of preventive measures in this case, the results will be fast and sustainable. Self-medication is very harmful to your health.

Cluster headaches are a rare disorder that usually affects men between the ages of twenty and forty. This disease is often considered quite mysterious, it is difficult to identify its exact causes, treatment of the disorder is also difficult due to the unpredictability of the attacks, their intensity and the rapid decrease in pain at the same time. It is worth knowing what are called the main risk factors for the development of cluster headaches, how you can prevent recurrent attacks.

Cluster headache: what is it

This phrase refers to attacks of acute, extremely intense pain, usually localized on one side of the head in the eye area, usually around it. Attacks occur for no apparent reason, usually at the same time of day. Pain during an attack can be so intense that it can provoke a suicide attempt, such cases have been recorded.

In women, this disease is quite rare, it usually affects men of working age. An attack of a cluster headache lasts from fifteen minutes to an hour, the time of its occurrence depends on the biorhythms of a particular person. One of the main difficulties is called the unpredictability of seizures, so a person simply does not have time to take pain medication, pain comes and goes too quickly.

Scientists researching cluster headaches have found several similarities in most men with the condition. At the same time, medicine cannot explain why these features are present. Scientists have found that most men with pain are tall, well-developed muscles, large jaw, rough skin, light eyes.

Also, men who smoke large volumes of cigarettes are more prone to cluster headaches. Drinking alcohol does not affect the onset of the disease; it can only worsen the condition during a series of attacks.

At the moment, scientists find it difficult to explain these patterns; there are also no suggestions on how to avoid the development of the disease. However, if a disease is identified, modern medicine can offer several treatment methods that will help relieve the effects of pain attacks and, if possible, avoid the following.

The disease code according to the ICD-10 registry is G44.0. However, this information is usually required exclusively by specialists; it does not say much to the patient himself.

Important! Sometimes cluster headaches are considered a type of migraine, but these diseases have completely different nature and treatment methods.

Causes of occurrence

Today, experts find it difficult to explain the causes of seizures. However, there is a connection between biological rhythms and the occurrence of pain. Probably, in people with cluster headaches, the natural regulation of sleep and wakefulness cycles is disrupted, due to erroneous signals during brain activity, painful attacks occur.

External factors influencing the occurrence of cluster beam headache are not identified. It is impossible to influence the onset of the disease, therefore, there are also no preventive measures against pathology.

There is a link between high-volume smoking and the onset of painful attacks, but if a person stops smoking, episodes still remain. Therefore, it is quite difficult to name smoking as one of the causes of cluster headaches, although when a disease is detected, experts recommend immediately quitting the bad habit.

Symptoms

The main symptom of cluster pain is severe, extremely intense pain around the eye, usually on one side of the head. It occurs at night, the attack lasts no more than an hour. In the future, pain during seizures can spread to the second part of the head. You should also pay attention to the following signs:

1. With a series of attacks, pain occurs at the same time every day, usually at night; in women, pain is not associated with the stage of the menstrual cycle.
2. During an episode, tachycardia may occur, vision impairment, face blush, while there are no diseases of the cardiovascular system.
3. Are episodes most common in spring? in autumn, at other times of the year they are not active.

It is important to see a doctor right away with these symptoms. When diagnosing, you should make sure that these symptoms are not signs of migraine and other diseases.

What can cluster headache lead to?

Intense attacks of pain sensations do not have negative consequences in themselves, they note that with age, with chronic episodes, the condition gradually improves. In the absence of preventive treatment, the intensity of pain attacks decreases over time.

However, this disease sometimes has another dangerous consequence. The pain during attacks is so severe that some people try to commit suicide to get rid of it. In addition, it usually occurs at night, after a person has gone to sleep, which significantly affects the regime, provokes lack of sleep, and reduces the performance of a person as a whole.

Important! Quite often, the patient experiences only one series of episodes in his entire life, then the disease disappears without a trace without consequences.

How often can it be repeated

In severe cases, seizures can recur several times per night, in general, there is usually a series of several episodes, after which the disease may not manifest itself for several months, years, or even decades.

The duration of a series of episodes can be from several days to several months, the patient usually experiences from one to several bouts of painful sensations per day. During this period, it is highly undesirable to consume alcoholic beverages.

Which doctor to contact

If you suspect cluster pain in the head, you should consult a doctor - a neurologist. Usually, the diagnosis can be made after analyzing the symptoms, although it is usually advised to immediately conduct an MRI, CT scan, sometimes the picture is supplemented by an ECG and other studies.

It is advised to consult a doctor after the first attack, subsequently it is recommended to keep a diary of headache, noting the time of the episode, its intensity, and other symptoms present during it. This will help with the diagnosis, selection of the appropriate treatment.

It is impossible to completely get rid of seizures and prevent their occurrence in the future, however, preventive treatment will help to begin to tolerate episodes easier, pain will not be so pronounced.

For especially severe, chronic episodes, it is recommended to undergo treatment in the clinic. The most common method is using an oxygen mask and requires a gas cylinder and mask. This technique should be used under the supervision of a specialist so that it is as effective as possible and does not provoke side effects.

Home treatment

At home, you can remove the consequences of an attack: after it, the ears usually fill up, they begin to hurt, tachycardia and rhythm disturbances occur, and sleep problems. A number of drugs are used for these purposes; before using them, you need to consult a doctor.

To relieve pain and congestion in the ears, use ear drops for cluster headache: Otipax and its analogs with an analgesic effect, lidocaine. For short episodes that are often repeated, corticosteroids are used. Usually Prednisolone is used, this drug is most effective.

For preventive treatment, calcium channel blockers are used, usually in combination with prednisolone. The most effective drug in this group is Verapamil, it rarely causes side effects, therefore it is used most actively.

Folk remedies

Traditional medicine is not very effective for cluster headaches, but some folk remedies can help cope with the consequences of an attack in the form of tachycardia and stress.

To make the episodes of painful sensations easier, it is recommended to include walnuts and turmeric in the diet. They contain substances that are useful for headaches of various origins. Every day it is advised to eat several pieces of pure walnuts; turmeric should be added as a seasoning to food.

In general, with properly selected preventive treatment, attacks will become easier to tolerate. It is important to constantly monitor your conditions, keep a diary of observations in order to track the dynamics of changes in this disease.

Cluster headache - This is a fairly rare syndrome, covering a headache of a narrow localization, usually in the periocular region. It is more common among men (5: 1 in relation to the female population), but in general in the population it occurs in three people out of a thousand. The disease usually debuts at a young age. Some doctors consider it a type of migraine, but this is not the case.

The mechanism of development of cluster pain is somewhat reminiscent of migraine pain: the same trigeminovascular system is activated, pain neuropeptides are formed, and vasodilation takes place. However, detailed studies show that the basis of the pathogenesis of cluster headache is also a violation of the pacemaker function of the hypothalamus, which in this case determines the occurrence of painful periods and the seasonality of exacerbations. The rhythmic activation of the hypothalamic region is followed by the activation of the trigeminovascular system, dilatation of the vessels of the dura mater, the release of painful neuropeptides, after which the patient is faced with an attack. The subsidence of exacerbation and the onset of remission indicate the normalization of hypothalamic activity.

The involvement of the hypothalamic zones in the formation of cluster pain later explained the daily frequency of pain attacks, the dependence of attacks on sleep periods (very often cluster headache manifests itself an hour or two after falling asleep, it will also remind of itself later), the peculiarity of behavior patients.

To date, studies are underway on the mechanism of action of pain-provoking factors on the sensitive areas of the hypothalamus. The nature of paroxysmal hemicrania, short-term unilateral neuralgic headaches with conjunctival injection and lacrimation remains unexplained.

Causes of cluster headache in many respects coincide with triggers of other forms, but there are also specific ones among them, for example:

• a sharp change in time zones (for example, when flying),
• due to insomnia
• shift work schedule and biorhythm failure (for example, with a daily work schedule),
• consumption of substances such as alcohol, histamine, nitroglycerin.

The clinical picture of cluster headache includes:

• the strongest intensity attacks of pain, lasting from 15 minutes to 3 hours;
• the frequency of attacks (therefore, this type of pain is also called "bundle") - occur in series from several weeks to several months with long-term remissions (seasonality is often inherent);
• localization of pain - one-sided, not spilled; around the eyes, in the region of the eyebrows, in the temporal region; occasionally radiates to the upper and lower jaw;
• the frequency of attacks - from several times a day to once in a few days; often at night;
• intolerance of pain provokes restlessness, throwing the patient, crying, aggression, anxiety;
• at the peak of pain, vegetative symptoms join - redness of the conjunctiva, lacrimation, nasal congestion, rhinorrhea, sweating of the forehead and face, swelling of the eyelids.

Most often, an episodic form of cluster headache is observed, less often - a chronic one, when remissions are either absent at all, or do not last more than a month.

How to Treat Clustered?

Has several directions:

• relief of an attack, that is, symptomatic treatment,
• prevention of pain attacks, that is, preventive measures aimed at reducing the frequency of attacks and achieving the longest possible remission.

Treatment of episodic cluster pain requires fewer interventions than chronic pain. However, ignoring the syndrome at the stage of its episodicity entails aggravation and chronicity of the process.

When relieving attacks of cluster pain, use:

• triptans (sumatriptan, eletriptan, zolmitriptan),
• ergotamine preparations (nomigren, cofetamine),
• inhalation of 100% oxygen (7-10 l / min for 15 minutes).

Local anesthetics such as lidocaine (in the form of nasal drops or aerosol) and capsaicin-containing drugs can also demonstrate effectiveness. The analgesics so popular in pain relief, including opioids, should not be used to relieve cluster headache attacks.

Prevention of episodic cluster pain is recommended to start as early as possible from the onset of the pain period. Even with a noticeable improvement during the first 1-2 weeks of therapy, patients should not interrupt the course: the treatment should be continued for the entire expected painful "bundle" and completed 2 weeks later after achieving complete remission. There is evidence of the effectiveness of anticonvulsants (gabapentin, topiramate) in patients with prolonged painful periods and a chronic form of cluster headache.

With an episodic form and a relatively mild course of the syndrome, lithium carbonate and verapamil have a good effect, if necessary, a combination of these drugs is possible. With a more severe course (more than five attacks per day and the duration of the pain beam more than 2 months), the use of anticonvulsants and gabapentin is indicated.

Treatment of chronic cluster pain is difficult. If these approaches are ineffective, the use of glucocorticoids is possible. With the ineffectiveness of drug approaches and severe chronic forms, surgical methods of treatment can be used:

• radio frequency thermocoagulation of the trigeminal ganglion,
• radio frequency rhizotomy,
• microvascular decompression,
• some methods of neurostimulation, such as deep stimulation of the posterior hypothalamic region, the greater occipital, vagus and other nerves.

What diseases can it be associated with

Episodic cluster pain is complicated by the transition to chronic pain. This happens in 10-15% of cases. In some patients, the opposite tendency is also noted - the transition of the chronic form to the episodic one. Some patients have a combination of cluster headache and trigeminal neuralgia - this is called cluster tic syndrome.

Treating cluster headache at home

Cluster headache treatment easy to implement at home. Often, patients do not even go to the doctor, stopping attacks with widely available analgesics and antispasmodics. At the same time, the treatment prescribed by a professional physician will be more productive, because the doctor determines the form of the headache, understands the mechanisms of its development and prescribes a pharmacological drug that is effective in this particular case. Drugs should be selected based on efficacy and toxicity. The ineffectiveness of one drug does not mean the ineffectiveness of the other, it is possible to use a combination of them. Due to the potential toxicity of the drugs, the instructions for their use must be followed.

Medication treatment of cluster headaches must certainly occur against the background of changes in the lifestyle and daily routine of the patient. The goal is to eliminate the factors provoking attacks:

• do not take alcohol,
• use any medications with caution (they can become a trigger),
• with caution to consume foodstuffs with vasodilatory properties,
• observe the sleep-wake regime.

What drugs to treat cluster?

• Verapamil - 240-960 mg per day;
• Prednisolone - 60-80 mg once a day for 2-4 days, followed by a dose reduction within 2-3 weeks;
• Lithium carbonate - 600-1600 mg / day;
• Ergotamine tartrate - 2-4 mg per day rectally;
• Metisergide - 1-2 mg tablets

Treatment of cluster headache with alternative methods

The use of folk remedies can be an excellent addition to the methods of traditional medicine. The nature of the occurrence of cluster pain suggests that its elimination with folk remedies is hardly effective. However, it is quite affordable to ease the symptoms of the disorder. Discuss with your doctor the advisability of using such improvised means, their compatibility with the prescribed pharmacological drugs:

• turmeric - has a sedative and anti-inflammatory properties, and therefore can be widely used in the diet of people suffering from headaches;
• walnuts - widely recognized antioxidants, have a beneficial effect on blood circulation, improve blood composition, calm the nervous system and strengthen the immune system;
• cayenne pepper - some of the substances contained in it have an irritating effect, and therefore pepper-based ointments are excellent pain relief when applied to the temple area.

Do not diminish the importance of massage using essential oils, therapeutic exercises, yoga.

Treatment for cluster headache during pregnancy

Cluster headache treatment during pregnancy is not very popular, since the disease itself is rare and less popular among women than among men. At the same time, it can make its debut precisely at childbearing age (20-40 years) and it is possible that against the background of pregnancy.

The onset or exacerbation (recurrence) of headaches in a pregnant woman should be a reason to visit a specialized specialist or discuss acceptable medications with a gynecologist leading the pregnancy. The goal of treating cluster pain in the expectant mother is to normalize her performance and well-being. The least toxic pharmacological preparations are used. the benefits of their use should exceed the risk for a developing fetus and the load on the cardiovascular system of a pregnant woman at times. Specific names are discussed with the attending physician at an in-person consultation. It is permissible to use phytopreparations and herbal components, however, they do not have a clear and proven effect in cluster pain.

Which doctors should you contact if you have a cluster

The diagnosis of cluster headache is based on a typical clinical presentation. The doctor takes into account the patient's complaints of exclusively one-sided pain in half of the face and head, accompanied by vegetative manifestations. If there is a characteristic course of the disease in the anamnesis (that is, painful periods alternate with intervals of remission), this adds confidence in the diagnosis. As additional criteria of a cluster headache, its unbearable nature, anxiety and agitation of the patient, the occurrence of attacks during a night's sleep are considered.

Diagnostic criteria for cluster headache:

• intense or extremely intense unilateral pain of orbital, supraorbital and / or temporal localization lasting 15-180 minutes (without taking pharmacological drugs);
• the headache is accompanied by at least one of the following symptoms on the pain side:
  • injection of the conjunctiva and / or lacrimation;
  • nasal congestion and / or rhinorrhea;
  • swelling of the eyelids;
  • sweating of the forehead and face;
  • miosis and / or ptosis;
  • feeling anxious (unable to be at rest) or agitation
• frequency of attacks - from 1 time in 2 days to 8 times a day;
• other disorders and disorders are not observed.

Traditional methods of research (EEG, MRI, USDG) are considered deliberately uninformative; their use is advisable in case of an atypical clinical picture of headaches, when it is necessary to exclude their secondary nature. It is advisable to suspect the secondary nature of cluster headache in the presence of the following atypical symptoms:

• insufficient pain intensity, the patient is able to be at rest during an attack,
• no night attacks,
• the presence of a "background" headache between attacks,
• the presence of neurological symptoms in the patient's status (except for miosis and ptosis),
• ineffectiveness of traditional means of arresting seizures (triptans, ergotamine, oxygen inhalation).

The most informative diagnostic methods when excluding the secondary nature of cluster headache are MRI and CT with contrast.

The sensation of pain in the head is familiar to every person. More often it is aching, pressing, captures the entire head or spreads to its individual parts. A common headache is rarely very severe, and many get used to it. However, there is a special type of this condition - cluster, or bundle headache, which is the most painful and causes great suffering. Painful sensations arise in paroxysms and are concentrated at one point, usually in the orbit. In the interictal period, there are usually no manifestations.

About 1% of the world's population suffers from cluster headache, and the overwhelming majority are representatives of the stronger sex. Attacks of cluster headache not only worsen the quality of life of patients, but also significantly limit their ability to work. The age of onset of the disease ranges from 25 to 55 years. The reasons include a change in the usual daily routine (shift work, frequent air travel with a change of time zones), alcohol consumption, smoking.

Symptoms of cluster headaches

Time characteristics. Attacks of cluster headache are regular, usually begin at the same time of day, the most intense at night ("pain-alarm"). They occur with a frequency of 2-3 times a day to once a week. The duration of one attack can be from 15 to 90 minutes. The exacerbation period lasts from 2 to 10 weeks, then remission occurs up to 2-3 years.

Pain. It occurs abruptly - unlike a tension headache (odna_stat.php? Id \u003d 787), it takes a person by surprise, there are no harbingers of an approaching attack. By nature, it is extremely strong, burning, piercing, reaches a maximum within a minute.

Localization of pain. It always appears always on one side of the head, most often behind the eyeball or around the eye. It can radiate to the ear, forehead, cheek, temporal region.

Associated signs:

• redness of the face and the eye itself;
• unilateral vegetative manifestations: nasal congestion, lacrimation, sweating of the skin on the face and neck;
• palpitations;
• swelling of the eyelid;
• intolerance to bright light and loud sounds.

Mental manifestations. With a cluster headache, a person may experience excitement, irritability, sometimes inappropriate behavior is observed on his part. Some have suicidal thoughts and attempts (rarely).

The cluster headache is so strong and unexpected that a person, in the midst of complete health, begins to rush around the room, clasps his head with his hands, screams, moans, cries, tries to find a position that would alleviate the condition. This causes horror and fear in those who witnessed the attack.

Treatment of cluster headaches

If you have a severe headache, you should definitely consult a neurologist. Usually, a detailed description of the nature and frequency of seizures is sufficient to make a diagnosis. Neurological examination in the case of cluster headache will not reveal any abnormalities. The doctor will definitely prescribe an MRI to exclude organic diseases of the brain.

Measures to stop an attack:

1. Try to calm down and relax.

2. If possible, breathe in 100% oxygen through the mask for 5-10 minutes. At home, just open a window or go out into the fresh air. Take deep and measured breaths in and out.

3. Apply something cold to your temples.

4. Medicines:

• pain relievers (analgin);
• non-steroidal anti-inflammatory drugs (naproxen, ibuprofen);
• sedatives and hypnotics (valerian, diphenhydramine, sonnat);
• vitamins (B1, B12, magne B6).

Intramuscular injections of the mixture are effective: analgin, diphenhydramine, vitamin B12.

In recent years, drugs based on triptans have been used, which give a quick effect: a nasal spray with sumatriptan, dihydroergotamine.

Preventive treatment is prescribed to prevent potential attacks and reduce their frequency:

• verapamil;
• prednisone;
• topirol;
• lithium preparations;
• depakin;
• zolmitriptan.

The type of drug, dose and duration of administration is determined by the doctor in each specific case, since they have many side effects and the risk-benefit ratio must be taken into account. Sometimes, over time, it is possible to reduce the dosage to the minimum. Some have to take medication all the time.

Non-drug methods:

• acupuncture;
• laser therapy to the points of greatest pain;
• darsonvalization of the scalp;
• psychotherapy;
• elimination of provoking factors;
• walks in the open air.

Treatment with folk remedies at home

1. Lemon. Cut off the lemon zest (without the white part), immerse in freshly boiled water for a minute. Attach to the temples.
2. Ginger. Pour a tablespoon of grated root with a glass of boiling water and let it brew for 10 minutes. Drink as tea in the morning on an empty stomach. The course of treatment is 3 weeks, then a break is 1 month.
3. Healing baths with lavender or lemon oil. Add 7-10 drops to the water, take a bath for 15 minutes.
4. Apple vinegar. Dissolve 1 tablespoon in 500 ml of cold water. Wet gauze and apply on the forehead