Cluster headache
| Trigeminal autonomic cephalalgia | |
|---|---|
| Etiology | Night-time headache, into up to eight attacks per day each lasting between 15 and 180min |
| Epidemiology | M>F. May have FHx. Smoking, head injury, alcohol. |
| Clinical presentation | Retro-orbital pain Associated symptoms, often unilateral, include conjunctival injection, lacrimation, nasal congestion, rhinorrhoea, forehead, and facial sweating, miosis, ptosis |
| Pathogenesis | |
| Diagnostic investigations | Brain imaging to exclude 2o causes? |
| Management | - High flow O2 (12L/min via reservoir mask) for 15min sometimes provides relief - preferred in pregnant patients - SC sumatriptan (may also be IN) - prevention with verapamil - on specialist advice only |