Very severe headache with involvement of the trigeminal nerve, typically affecting one side of the skull.
The exact cause is unknown, although it is thought to be the result of a combination of genetic predisposition and exposure to environmental factors: alcohol, nitroglycerine, perfumes, inhalation of petroleum derivatives and tobacco (up to 85% of patients are smokers).
It presents with a very intense headache in the form of outbreaks that last from fifteen minutes to three hours. It usually recurs at the same time of the day. It is accompanied by tearing and reddening of one eye, drooping of the eyelid, runny nose and sweating on the same side of the face.
Diagnosis is clinical, by interrogation and physical examination.
Pain should be controlled with analgesics, oxygen inhalation and relaxation techniques. Triptans (migraine medication) have been shown to be effective in reducing pain. In recurrent cases, it can be prevented with medication such as verapamil +/- cortisone.
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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.
