Cluster Headache


Cluster headache is an excruciatingly painful problem, a ‘suicide headache’. It is secondary to various manifestations of autonomic nervous system dysfunction. Correct diagnosis is clinically mandatory and must be followed with appropriate abortive and prophylactic medications.

Keywords: headache; chronic paroxysmal hemicrania; autonomic nervous system


D'Alessandro R, Ganberini G, Benassi G, et al. (1986) Cluster headache in the Republic of San Marino. Cephalalgia 6: 159–162.

Di Piero V, Fiacco F, Tombari D and Pantano P (1997) Tonic pain: a SPECT study in normal subjects and cluster headache patients. Pain 70: 185–191.

Fanciullacci M, Alessandri M, Figini M, et al. (1995) Increases in plasma calcitonin gene‐related peptide from extracerebral circulation during nitroglycerine‐induced cluster attack. Pain 60: 119–123.

Galeotti N, Ghelardini C, Zoppi M, et al. (2001) Hypofunctionality of Gi proteins as aetiopathogenic mechanism for migraine and cluster headache. Cephalalgia 21: 38–45.

Goadsby PJ and Edvinsson L (1988) Release of vasoactive peptides in the extracerebral circulation of humans and the cat during activation of the trigeminovascular system. Annals in Neurology 23: 193–196.

Goadsby PJ and Edvinsson L (1994) Human in vivo evidence for trigeminovascular activation in cluster headache. Neuropeptide changes and effects of acute attacks therapies. Brain 117: 427–434.

Goadsby PJ (1997) Current concepts of the pathophysiology of migraine. Neurologic Clinics of North America 15: 27–41.

Graham JR (1975) Some clinical and theoretical aspects of cluster headache. In: Saxena, PR (ed.) Migraine and Related Headaches, pp. 27–40. Rotterdam, The Netherlands: Erasmus Universiteit.

Horton BT, MacLean AR and Craig WM (1939) A new syndrome of vascular headache: results of treatment with histamine: preliminary report. Mayo Clinic Proceedings 14: 257–260.

Klapper JA, Klapper A and Voss T (2000) The misdiagnosis of cluster headache: a nonclinic, population‐based, internet survey. Headache 40: 730–735.

Kudrow L (1980) Cluster Headache: Mechanisms and Management. New York: Oxford University Press.

Kunkle EC, Pfeiffer JB Jr, Wilhoit WM and Hamrick LW Jr (1954) Recurrent brief headaches in ‘cluster’ pattern. North Carolina Medical Journal 15: 510–512.

Lainez MJ, Pascual J, Santonja JM, et al. (2001) Topiramate in the prophylactic treatment of cluster headache. Cephalalgia 21: 369. Abstract and poster presented at the 10th Congress of the International Headache Society, New York. Abstract P3‐R20. 29 June–2 July, 2001.

Leone M, Franzini A, D'Amico D, et al. (2001) Intractable chronic cluster headache relieved by electrode implant to posterior inferior hypothalamus. Cephalalgia 21: 503.

Manzoni GC (1998) Gender ratio of cluster headache over the years: a possible role of changes in lifestyle. Cephalalgia 18: 138–142.

Mathew NT and Hurt W (1988) Percutaneous radiofrequency trigeminal gangliorhizolysis in intractable cluster headache. Headache 28: 328–331.

May A, Bahra A, Buchel C, Frakowiak RSJ and Goadsby PJ (1998) Hypothalamic activation in cluster headache attacks. Lancet 351: 275–278.

Morrow TJ, Koeppe RA and Casey KI (1995) Involvement of the insular cortex in central autonomic regulation during painful thermal stimulation. Journal of Cerebral Blood Flow 15(Suppl. 1): 859.

Rasmussen BK (1999) Epidemiology of cluster headache. In: Olesen J and Goadsby P (eds) Cluster Headache and Related Condition. New York, Oxford University Press, pp. 23–26.

Romberg MH (1840) Lehrbuch der Nervenkrankheiten des Menschen, BD I, pp. 58–60. Berlin: Dunker.

Taha JM and Tew JM (1995) Long‐term results of radiofrequency Rhizotomy in the treatment of cluster headache. Headache 35: 193–196.

Torelli P and Manzoni GC (2002) What predicts evolution from episodic to chronic cluster headache?. Current Pain and Headache Reports 6: 65–67.

The Sumatriptan Cluster Headache Study Group (1991) Treatment of acute cluster headache with sumatriptan. The New England Journal of Medicine 325: 322–326.

Wheeler S and Carrazana EJ (1999) Topiramate‐treated cluster headache. Neurology 53: 234–236.

Further Reading

Jay GW (1998) Headache Handbook: Diagnosis and Treatment. Boca Raton, FL: CRC Press.

Sjaastad O (1992) Cluster headache syndrome. In: Major Problems in Neurology, vol. 23. London: Saunders.

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Jay, Gary W(Sep 2005) Cluster Headache. In: eLS. John Wiley & Sons Ltd, Chichester. [doi: 10.1038/npg.els.0004074]