Ver el código de «Cluster headache»

==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.  
*Triggers may be alcohol, nitroglycerin, histamine

===Definition<ref>International Headache Society Diagnostic Criteria</ref>===
''At least 5 attacks of headache fulfilling the following criteria:''
#Severe '''unilateral''' orbital, supraorbital, or temporal pain lasting 15–180 min if untreated
#[[Headache]] accompanied by at least one of the following:
#*Ipsilateral conjunctival injection and/or lacrimation
#*Ipsilateral nasal congestion and/or rhinorrhea
#*Ipsilateral eyelid edema
#*Ipsilateral forehead and facial sweating
#*Ipsilateral miosis and/or ptosis
#*A sense of restlessness or agitation
#Attacks have a frequency from one every other day to eight per day
#Not attributed to another disorder

==Differential Diagnosis==
{{Headache DDX}}

==Evaluation==
*Consider other emergent causes of [[headache]] based on H&P
**Consider [[head CT|CT]], [[LP]], and/or eye pathology 
*Typically a clinical diagnosis

==Management==
*High-flow [[O2]] (effective in 70% of patients)<ref>Headache. 2013 Jul-Aug;53(7):1191-6. doi: 10.1111/head.12145. Epub 2013 Jun 14. Cluster headache: conventional pharmacological management. Becker WJ1.</ref>
*Intranasal [[lidocaine]] 4%
*DHE
*[[Sumatriptan]]
*Intranasal zolmitriptan
*Subcutaneous or IM dihydroergotamine and intranasal sumatriptan are additional options
*[[Verapamil]] can be used for prophylaxis
*[[Prednisone]] taper with [[verapamil]] has shown to reduce frequency of attacks<ref>Obermann M, Nägel S, Ose C, et al. Safety and efficacy of prednisone versus placebo in short-term prevention of episodic cluster headache: a multicentre, double-blind, randomised controlled trial. Lancet Neurol. 2021;20(1):29-37. doi:10.1016/S1474-4422(20)30363-X</ref>

==Disposition==
*Normally outpatient

==See Also==
*[[Headache]]

==References==
<references/>

[[Category:Neurology]]