Cluster Headache

Cluster headache is an uncommon facial pain/headache disorder in which there are excruciating attacks of pain on one side of the face, usually around the eye. These attacks can last from minutes to hours, and they are often accompanied by a runny nose, eye watering or redness, or other autonomic symptoms.

The cause of cluster headaches is unclear, but the attacks may relate to a sudden release of histamine or serotonin in the body. Patients are advised to avoid triggers for the attacks. Common triggers include tobacco, alcohol, heat, foods containing nitrates, sudden altitude changes, and exercise. Treatments include oxygen or triptans (during an attack) as well as several medications that may help prevent attacks.

For patients who continue to have severe cluster headache attacks despite the above measures, there are several surgical options, including sphenopalatine ganglion (SPG) rhizotomy, occipital nerve stimulation, and trigeminal nerve stimulation. The latter two can be quite effective, but they require a permanent stimulator implant that is not MRI compatible, and they are seldom covered by insurance plans. For these reasons, SPG rhizotomy is a good starting place for many patients.

If you live near Denver and suffer from cluster headaches or another facial pain disorder, please consider meeting me in consultation to learn whether you might be a candidate for one of the above therapies.