These are like migraines in that they come & go, and are diagnosed entirely by their pattern of occurrences & symptoms. Cluster Headaches:
- Occur daily, or every other day, usually for 6-12 weeks [range: anywhere from 1 week to 1 year], then disappear for at least a month, then recur.
- Each attack lasts 15 minutes to 3 hours. They may strike 1 to 8 times a day.
- The headache is severe, one-sided, felt around the eye or temple.
There’s at least one other finding on the same side as the headache:
- red eye or tearing, eyelid swelling, pupil constriction, or droopy eyelid
- runny nose [nostril] or congestion
- loss of forehead or facial sweating (only detectable if the other side sweats)
- restlessness or agitation [this would be in general]
If Cluster Headache is diagnosed, an MRI of the brain is usually recommended, because a disproportionate number of patients with typical signs & symptoms of cluster headache happen to have brain abnormalities, suggesting that some of these may be related.
Cluster headaches are much less common than migraines. There’s about a 1/1,000 lifetime chance; men may outnumber women 4:1. Like migraines, there are various treatments to stop the headaches, & to prevent them. But since a number of other headache variations mimic clusters, with shorter duration and more frequent bursts, we’d likely refer to a neurologist if treatment wasn’t working.
If we diagnose cluster headaches, we need to ask how the patient is coping. There have been suicides among cluster headache sufferers.
Chronic cluster headaches also occur in short bursts several times a day, on one side of the head (usually behind the eye). There may be funny symptoms around that one eye like a droopy eyelid, tearing, tiny pupil, or runny nose / loss of forehead sweat on just the one side.
But chronic cluster headaches don’t go away; if they do, they’re back again within a month. They can be simply terrible. The condition is very rare, but any possibility of it would lead us refer to a neurologist (preferably a headache specialist). Patients with chronic cluster headaches can be truly miserable and depressed.