Cluster Headache
CLUSTER HEAD ACHE (MIGRAINOUS NEURALGIA)
Etiology:
- Cluster headache is likely a disorder involving central pacemaker neurons in the region of the posterior hypothalamus, causing excruciating henticranial pain.
Symptoms:
- Young adult men
- The pain is unilateral, deep, usually retro orbital, excruciating, non-fluctuating and explosive in quality
- A core feature of cluster headache is periodicity. Pain recurs at the same hour each day for 8 to 10 weeks a year; followed by a pain-free interval
- Patients are generally perfectly well between episodes
- Often occurs at night 2 hrs after sleep, wakes up the patient from sleep
- Associated with vasomotor phenomenon – rhinorrhea, conjunctival injection, nasal congestion, lacrimation, ptosis or Horner’s syndrome
- These defects occur due to parasympathetic activation which occur as a result of injury to ascending sympathetic fibers surrounding a dilated carotid artery as it passes into the cranial cavity.
Treatment:
- Prednisone used for short term prevention; verapamil for long term prevention
Exam Important
Symptoms:
- Young adult men
- The pain is unilateral, deep, usually retro orbital, excruciating, non-fluctuating and explosive in quality
- A core feature of cluster headache is periodicity. Pain recurs at the same hour each day for 8 to 10 weeks a year; followed by a pain-free interval
- Patients are generally perfectly well between episodes
- Often occurs at night 2 hrs after sleep, wakes up the patient from sleep
- Associated with vasomotor phenomenon – rhinorrhea, conjunctival injection, nasal congestion, lacrimation, ptosis or Horner’s syndrome
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