Cluster headache: Difference between revisions

No edit summary
No edit summary
Line 4: Line 4:


==Definition==
==Definition==
*At least 5 attacks of HA fulfilling the following criteria:
*At least 5 attacks of headache fulfilling the following criteria:
**1. Severe unilateral orbital, supraorbital, or temporal pain lasting 15–180 min if untreated
#Severe unilateral orbital, supraorbital, or temporal pain lasting 15–180 min if untreated
**2. HA is accompanied by at least one of the following:
#Headache accompanied by at least one of the following:
***a. Ipsilateral conjunctival injection and/or lacrimation
##Ipsilateral conjunctival injection and/or lacrimation
***b. Ipsilateral nasal congestion and/or rhinorrhea
##Ipsilateral nasal congestion and/or rhinorrhea
***c. Ipsilateral eyelid edema
##Ipsilateral eyelid edema
***d. Ipsilateral forehead and facial sweating
##Ipsilateral forehead and facial sweating
***e. Ipsilateral miosis and/or ptosis
##Ipsilateral miosis and/or ptosis
***f. A sense of restlessness or agitation
##A sense of restlessness or agitation
**3. Attacks have a frequency from one every other day to eight per day
#Attacks have a frequency from one every other day to eight per day
**4. Not attributed to another disorder
#Not attributed to another disorder


==Diagnosis==
==Diagnosis==

Revision as of 07:58, 4 April 2015

Background

  • Occur most often in middle aged men
  • Classically occur in "clusters" over days to weeks typically at the same time of day and same anatomical location.

Definition

  • At least 5 attacks of headache fulfilling the following criteria:
  1. Severe unilateral orbital, supraorbital, or temporal pain lasting 15–180 min if untreated
  2. Headache accompanied by at least one of the following:
    1. Ipsilateral conjunctival injection and/or lacrimation
    2. Ipsilateral nasal congestion and/or rhinorrhea
    3. Ipsilateral eyelid edema
    4. Ipsilateral forehead and facial sweating
    5. Ipsilateral miosis and/or ptosis
    6. A sense of restlessness or agitation
  3. Attacks have a frequency from one every other day to eight per day
  4. Not attributed to another disorder

Diagnosis

Work-Up

Differential Diagnosis

Headache

Common

Killers

Maimers

Others

Aseptic Meningitis

Treatment

  • High-flow O2 (effective in 70% of pts)
  • DHE
  • Sumatriptan

Disposition

  • Normally outpatient

See Also

Source

  • Tintinalli
  • International Headache Society Diagnostic Criteria