Editing Cluster headache (section)

{{Short description|Neurological disorder}}
{{Use dmy dates|date=April 2023}}
{{Infobox medical condition (new)
| name          = Cluster headache
| image         = Gray778.png
| caption       = [[Trigeminal nerve]]
| field         = [[Neurology]]
| symptoms      = Recurrent, severe [[headache]]s on one side of the head, eye watering, stuffy nose<ref name=Nesbitt2012/>
| complications = 
| onset         = 20 to 40 years old<ref name=AFP2013/>
| duration      = 15 minutes to 3 hours<ref name=AFP2013/>
| types         = Episodic, chronic<ref name=AFP2013/>
| causes        = Unknown<ref name=AFP2013/>
| risks         = [[Tobacco smoke]], family history<ref name=AFP2013/>
| diagnosis     = Based on symptoms<ref name=AFP2013/>
| differential  = [[Migraine]], [[trigeminal neuralgia]],<ref name=AFP2013/> other [[trigeminal autonomic cephalgias]]<ref>{{cite journal|last1=Rizzoli|first1=P|last2=Mullally|first2=WJ|title=Headache.|journal=The American Journal of Medicine|date=20 September 2017|doi=10.1016/j.amjmed.2017.09.005|pmid=28939471|volume=131|issue=1|pages=17–24|doi-access=free}}</ref>
| prevention    = [[Verapamil]], [[galcanezumab]], oral [[glucocorticoids]], [[steroid injections]], [[civamide]]<ref name=Rob2016/>
| treatment     = [[Oxygen therapy]], [[triptan]]s<ref name=AFP2013/><ref name=Rob2016/>
| medication    = 
| prognosis     = 
| frequency     = ~0.1% at some point in time<ref name=Fis2008/>
| deaths        = 
}}

<!-- Definition and symptoms -->
'''Cluster headache''' is a [[neurological disorder]] characterized by recurrent severe [[headache]]s on one side of the head, typically around the [[eye|eye(s)]].<ref name="Nesbitt2012" /> There is often accompanying eye watering, [[nasal congestion]], or swelling around the [[eye]] on the affected side.<ref name="Nesbitt2012">{{cite journal |doi=10.1136/bmj.e2407 |pmid=22496300 |title=Cluster headache |journal=BMJ |volume=344 |pages=e2407 |year=2012 |last1=Nesbitt |first1=A. D. |last2=Goadsby |first2=P. J. |s2cid=5479248 }}</ref> These symptoms typically last 15 minutes to 3 hours.<ref name="AFP2013" /> Attacks often occur in clusters which typically last for weeks or months and occasionally more than a year.<ref name="AFP2013" /> The disease is considered among the most painful conditions known to medical science.<ref name="birth">{{cite journal |author=Matharu M, Goadsby P |year=2001 |title=Cluster Headache |journal=Practical Neurology |volume=1 |page=42 |doi=10.1046/j.1474-7766.2001.00505.x |s2cid=19601387 |doi-access=free}}</ref><ref>{{cite journal |last1=Matharu |first1=Manjit S |last2=Goadsby |first2=Peter J |year=2014 |title=Cluster headache: Focus on emerging therapies |journal=Expert Review of Neurotherapeutics |volume=4 |issue=5 |pages=895–907 |doi=10.1586/14737175.4.5.895 |pmid=15853515 |s2cid=43918900}}</ref>

<!-- Cause and diagnosis -->
The cause is unknown,<ref name="AFP2013" /> but is most likely related to dysfunction of the posterior [[hypothalamus]].<ref name=":2">{{Cite book |last=Goadsby |first=Peter J. |title=Harrison's Principles of Internal Medicine |publisher=McGraw Hill |year=2022 |isbn=978-1264268504 |edition=21st |language=English |chapter=Chapter 430}}</ref> Risk factors include a history of exposure to [[tobacco smoke]] and a [[Family history (medicine)|family history]] of the condition.<ref name=AFP2013/> Exposures which may trigger attacks include [[ethanol|alcohol]], [[nitroglycerin (medication)|nitroglycerin]], and [[histamine]].<ref name=AFP2013/> They are a [[primary headache disorder]] of the  [[trigeminal autonomic cephalalgia]]s (TAC) type.<ref name=AFP2013/> Diagnosis is based on symptoms.<ref name=AFP2013/>

<!--Treatment and prevention -->
Recommended management includes [[Lifestyle (sociology)|lifestyle]] adaptations such as avoiding potential triggers.<ref name=AFP2013/> Treatments for acute attacks include [[Oxygen therapy|oxygen]] or a fast-acting [[triptan]].<ref name=AFP2013>{{cite journal |pmid=23939643 |url=http://www.aafp.org/link_out?pmid=23939643 |year=2013 |last1=Weaver-Agostoni |first1=J |title=Cluster headache |journal=American Family Physician |volume=88 |issue=2 |pages=122–8 |access-date=24 July 2017 |archive-date=30 December 2019 |archive-url=https://web.archive.org/web/20191230055437/https://www.aafp.org/link_out?pmid=23939643 |url-status=live }}</ref><ref name=Rob2016>{{cite journal |doi=10.1111/head.12866 |pmid=27432623 |title=Treatment of Cluster Headache: The American Headache Society Evidence-Based Guidelines |journal=Headache |volume=56 |issue=7 |pages=1093–106 |year=2016 |last1=Robbins |first1=Matthew S. |last2=Starling |first2=Amaal J. |last3=Pringsheim |first3=Tamara M. |last4=Becker |first4=Werner J. |last5=Schwedt |first5=Todd J. |doi-access=free }}</ref> Measures recommended to decrease the frequency of attacks include [[steroid injections]], [[galcanezumab]], [[Zucapsaicin|civamide]], [[verapamil]], or oral [[glucocorticoid]]s such as [[prednisone]].<ref name=":2" /><ref name=Rob2016/><ref name=Gaul11>{{cite journal |last1=Gaul |first1=C |last2=Diener |first2=H |last3=Müller |first3=OM |year=2011 |title=Cluster Headache Clinical Features and Therapeutic Options |journal= Deutsches Ärzteblatt International|volume=108 |issue=33 |pages=543–549 |doi=10.3238/arztebl.2011.0543 |pmid=21912573 |pmc=3167933}}</ref> [[Nerve stimulation]] or surgery may occasionally be used if other measures are not effective.<ref name=AFP2013/><ref name=":2" />

<!-- Epidemiology, history, and culture -->
The condition affects about 0.1% of the general population at some point in their life and 0.05% in any given year.<ref name=Fis2008/> The condition usually first occurs between 20 and 40 years of age.<ref name=AFP2013/> Men are affected about four times more often than women.<ref name=Fis2008>{{cite journal |doi=10.1111/j.1468-2982.2008.01592.x |pmid=18422717 |title=The Incidence and Prevalence of Cluster Headache: A Meta-Analysis of Population-Based Studies |journal=Cephalalgia |volume=28 |issue=6 |pages=614–8 |year=2008 |last1=Fischera |first1=M |last2=Marziniak |first2=M |last3=Gralow |first3=I |last4=Evers |first4=S |s2cid=2471915 |doi-access=free }}</ref> Cluster headaches are named for the occurrence of groups of headache attacks (clusters).<ref name=Nesbitt2012/> They have also been referred to as "'''suicide headaches'''".<ref name=AFP2013/>