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Clinical Medicine Cluster Headache Month 2 Week 4 T3
Clinical Medicine Cluster Headache Month 2 Week 4 T3
9
Medical
Graduate
10/22/2018

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Term
Cluster Headache
Definition
• Most uncommon of the primary headaches
• Males>females (5:1)
• Marked by periods of recurrent headaches (1- 8/day) interspaced with periods of remission
• 90% of patients, these headaches are episodic
• Aggravated by alcohol, high altitude, exercise, nitrates, vasodilators, change in sleep
Term
Cluster Headache – IHS Criteria
Definition
- 5 attacks fulfilling the following:
- Severe unilateral orbital, supraorbital and/or temporal pain lasting 15
to 180 minutes untreated.
- Attack is associated with at least one of the following signs on the side of pain:
• Conjunctival injection
• Lacrimation
• Nasal Congestion
• Rhinorrhea
• Forehead and facial sweating
• Miosis
• Ptosis
• Eyelid edema
- Also, sense of restlessness or agitation (e.g. pacing)
- Attacks have frequency of one every other day to 8 per day
- No evidence on history or examination of disease that might cause headaches
Term
cluster headache clinical features
Definition
• Unilateral and severe
• Described as non-throbbing, boring, stabbing, burning, steady, located behind the eyes (but may occur elsewhere)
• Rapid onset with peak intensity in 5-10 minutes and usually short duration (30-45 minutes)
• Associated with ipsilateral nasal congestion, ipsilateral conjunctival injection, ipsilateral sweating on forehead
- May have ipsilateral Horner’s syndrome
Term
cluster headache findings
Definition
watery eye, drooping eyelid, runny nose
Term
Cluster Headache-Treatment agents
Definition
-Acute
• Triptans (subcutaneous, nasal spray)
• High-flow Oxygen through mask
- Transitional
• Corticosteroids • DHE
- Preventive
• Verapamil
• Lithium
• Topiramate
• Melatonin
• Methysergide
Term
preventative treatment for cluster headaches
Definition
- Preventative therapy
• Verapamil (Calan®)
• Lithium
• Valproate
Term
acute treatment for cluster headaches
Definition
• Inhaled 100% oxygen at a rate of 7-10L/minute for 15-20 minutes
• Sumatriptan
• DHE
Term
[image]
Definition
[image]
Term
visual depiction of different types of headaches
Definition
[image]
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