A very severe headache involving the trigeminal nerve, typically affecting one side of the skull.
The exact cause is unknown, although it is believed to be the result of a combination of genetic predisposition and exposure to environmental factors: alcohol, nitroglycerin, perfumes, inhalation of petroleum derivatives and tobacco (up to 85% of patients are smokers).
It presents with very intense headaches in the form of attacks lasting from fifteen minutes to three hours. It usually recurs at the same time of day. It is accompanied by tearing and redness of one eye, drooping of the eyelid, nasal discharge and sweating on the same side of the face.
The diagnosis is made clinically by interview and physical examination.
Pain should be controlled with analgesics, oxygen inhalation, and relaxation techniques. Triptans (migraine medications) have been shown to be effective in reducing pain. In recurrent cases, medication such as verapamil +/- cortisone can be used to prevent recurrence.
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- Goadsby, Peter J., Raskin, Neil H. Migrañas y otras cefaleas primarias. Cefalea en racimo. Harrison. Principios de Medicina Interna. Volumen 2. 19ª Edición. 2594:2596.
- A. Urbano-Márquez, R. Estruch. Generalidades. Cefalea acuminada (Cluster headache). Farreras Rozman. Medicina Interna. Volumen II. Duodécima edición. 1318.
