Cluster Headaches

Topic Overview

What are cluster headaches?

Cluster headaches are severe, one-sided headaches that happen in groups, or "clusters." They usually occur over weeks or months.

Cluster headaches can be so painful that you are not able to follow your normal routine or do your usual activities. The pain is often called the worst type of headache pain.

Cluster headaches come in cycles (also called cluster periods). Most people who get cluster headaches have one or two cluster periods each year. A cluster period might last 1 month or longer. After a cluster period ends, you may not get another headache for months or even years.

As you get older, it is likely that you'll have longer and longer times without headaches. At some point, you may not get cluster headaches ever again.

Having cluster headaches can be scary. But even though they are very painful, cluster headaches don't cause long-term harm. During a cycle, you may be able to reduce how often you have them, how bad they are, and how long they last.

What causes cluster headaches?

Experts aren't sure what causes cluster headaches. They run in families, but it's not clear why some people get cluster headaches and others do not.

What are the symptoms?

The main symptom of cluster headaches is a severe burning or sharp, piercing pain on one side of your head. The pain spreads out from your temple and eye. Your eye may become red, watery, or puffy. The eyelid may droop, and you may have a runny or stuffy nose on that side of your head.

See a picture of cluster headache symptoms .

The pain usually gets bad very fast. The pain gets worse within 5 to 10 minutes after the headache starts and can last for 30 minutes or longer.

Cluster headaches usually happen at the same time of day each time you get them. But they can happen at any time. You may have 1 to 8 headaches a day.

How are cluster headaches diagnosed?

A doctor can usually tell if you have cluster headaches by asking about your symptoms and examining you. You probably will not need tests such as a CT scan or an MRI. Your doctor may order other tests if he or she thinks your symptoms are caused by another disease.

How are they prevented and treated during a cycle?

There is no cure for cluster headaches. You can't do anything to prevent a cycle of cluster headaches from starting.

But as soon as a cycle starts, you can take medicine that may help prevent more headaches or reduce how many you have during a cycle. You take this medicine every day during the cycle.

Certain things may be more likely to cause a headache during a cycle. These are called triggers. Avoiding them may help prevent headaches. Triggers include:

• Drinking alcohol.
• Smoking.
• Sleep problems. It's best if you go to bed and wake up at the same time every day. Don't take naps.
• Stress.

When a headache starts, you can take medicine or breathe in oxygen from a machine to ease the pain or stop the headache. You use these treatments only when you feel a headache coming on. You don't use them every day.

Over-the-counter pain medicines, such as aspirin, acetaminophen, and ibuprofen, usually don't work for cluster headaches.

When a cluster headache begins:

• Start your treatment right away. Don't wait for the headache to get worse. Take your medicine exactly as planned with your doctor.
• Do what feels best. You may feel better if you walk, jog in place, sit, kneel, or stand. Lying down may make the pain worse.

If your treatment doesn't work, ask your doctor if you can try something else. It may take time to find what works best for you.

A headache diary can give you and your doctor clues to help you manage your headaches. Write down when and how often the headaches happen, how severe they are, and what you think may be causing them. Share this with your doctor.

Frequently Asked Questions

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	Headaches: Managing a headache

Cause

The cause of cluster headaches is not clear. They may be genetic, because you are more likely to develop cluster headaches if a parent or sibling has them.

Cluster headaches may be caused by a problem in an area of the brain called the hypothalamus, although the specific problem or abnormality that triggers cluster headaches is unclear.

Alcohol, sleep apnea (regularly stopping breathing during sleep), stress, or fatigue may trigger cluster headaches or make them worse after a cycle of headaches begins.

Symptoms

Symptoms of cluster headaches may include:

• Headaches that come on suddenly without warning.
• Pain that is severe, excruciating, piercing, burning, or sharp.
• Pain that affects only one side of the face, head, and neck.
• A drooping eyelid.
• A watery, red eye and a smaller (constricted) pupil on the affected side.
• A stuffy or runny nose on the affected side.
• Headaches that happen at the same time or times of day each time you get them (for example, a headache that usually happens 2 to 3 hours after you fall asleep).
• Pain that quickly intensifies, peaking within 5 to 10 minutes of onset.
• Intense pain that can last from several minutes to 3 hours.
• A sweaty forehead.
• A warm and red (flushed) face or forehead on the affected side.

You may have several minutes or hours of being headache-free until the next headache in the cycle begins. You may have from 1 to 8 headaches a day during a cycle. Between headaches, you may feel physically and emotionally exhausted. After the cycle of headaches stops, you may be headache-free for days, weeks, or even years before another cycle occurs.

See a picture of cluster headache symptoms .

Other conditions (such as migraine headaches or trigeminal neuralgia) can cause symptoms similar to cluster headaches. Your doctor will usually be able to distinguish these conditions from cluster headaches by a careful medical history and physical examination.

What Happens

Most people who have cluster headaches have 1 or 2 cycles of headaches a year, with each cycle lasting between 1 and 3 months. After the cycle has subsided, most people are in remission with no headaches for about 6 months to 2 years.

Cluster headaches usually happen at the same time or times of day each time you get them. For example, they may begin at night, within 2 to 3 hours of falling asleep. But they can also occur during the daytime. You may have 1 to 8 headaches a day.

Cluster headaches cause deep, stabbing pain usually in, around, or behind one eye. The pain may extend to the temple, forehead, cheek, upper teeth, or even the jaw on the same side as the pain. You may also have a stuffy or runny nose, watery eye, and drooping eyelid on the same side as the pain. The pain almost always stays on the same side during a cycle of headaches.

The pain of cluster headaches intensifies quickly-within 5 to 10 minutes of starting-and usually remains constant for about 30 to 45 minutes, and sometimes up to 3 hours. Cluster headaches can continue for days, weeks, or months before symptoms completely stop (remission). You may not have another cycle of cluster headaches for months or even years. Less commonly, the headache cycles may become chronic and continuous.

During a headache cycle, you may be restless, agitated, or unable to sit still. Some people find relief by pacing, sitting, kneeling, standing, or jogging in place. Applying steady pressure to the painful area may provide relief. Lying down may make the pain worse.

Afterward, the pain goes away, but the headache may leave you physically and emotionally exhausted. Another headache may occur within a short time.

Some people have a single cluster headache cycle and never have another one. During a cycle, some people have up to 8 headaches a day over 6 to 12 weeks, followed by headache-free periods that can last for weeks, months, or years.¹

As you get older, it is likely that you will have longer and longer times without headaches (remission). Eventually, the headaches may stop altogether.

What Increases Your Risk

Risk factors for cluster headaches include:

• Being male. More males than females get cluster headaches.
• Being between the ages of 30 and 40, although cluster headaches can begin at any age. It is rare for children age 10 or younger to have cluster headaches.

If you have already been diagnosed with cluster headaches, the risk of triggering a headache increases if you:

• Are a smoker or have been a smoker in the past. Many people with cluster headaches are current or previous tobacco smokers.
• Use alcohol. Alcohol can trigger a headache, especially when you are having a cycle of headaches.
• Take medicines (during a headache cycle) that contain histamine or nitroglycerin.

When To Call a Doctor

Call 911 or other emergency services immediately if:

• You have a very sudden, severe, "thunderclap" headache that seems to come on instantly and is not like any headache you have had before.
• A headache develops along with stiff neck, high fever, nausea, vomiting, lethargy, drowsiness, and confusion.
• A headache develops along with weakness, paralysis, numbness, visual disturbances, slurred speech, confusion, or behavior changes.
• The intense pain caused by cluster headaches leads to thoughts of suicide. Treatment can help relieve the pain from your headaches.

Call your doctor immediately if:

• Headaches begin abruptly with no previous history of headaches, especially if the pain is sudden and severe.
• Headaches develop after a recent fall or blow to the head.
• A headache develops gradually and occurs with confusion, lethargy, problems with walking, or loss of bladder or bowel control.

Call your doctor if:

• You are repeatedly awakened by a severe headache during the night or in the morning.
• You are 50 years old and are having your first severe headache.
• The pattern of your headaches changes.
• The headaches occur during or after physical exertion, sexual activity, coughing, or sneezing.
• Your headaches do not get better with medicine.
• Your headaches are interfering with your daily activities.
• The headaches occur with depression or anxiety.
• You begin having daily headaches that are not relieved with nonprescription pain relievers.
• A child's headaches occur daily or are becoming worse with time.

Not all frequently occurring headaches are cluster headaches. For more information, see the topic Headaches.

Watchful Waiting

Cluster headaches need to be treated with prescription medicines, so watchful waiting is not appropriate. If you think you may have cluster headaches, see your doctor.

Who To See

If you think you have cluster headaches, treatment may reduce the frequency and severity of the cycles. The following doctors can diagnose and treat cluster headaches:

• Family medicine physician
• General practitioner
• Internist
• Neurologist

Headache clinics are also able to evaluate and treat cluster headaches. When you are looking for the right headache clinic, ask a few questions about the services provided-such as what types of specialists are at the clinic-so that you can find the clinic that is best for you.

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Exams and Tests

Your doctor will be able to diagnose cluster headaches with a medical history and physical exam. Cluster headaches have a classic set of symptoms, so your doctor usually can make a diagnosis based on your description of the headaches. Imaging tests are not commonly needed to help find a treatment for your pain.

If your cluster headaches are not helped by treatment, become chronic, or didn't begin until you were over age 50, your doctor may order imaging tests to rule out other causes for the headaches. Imaging tests may also be ordered if the pattern or symptoms of your headaches change, you develop a serious medical condition such as cancer or diabetes, or the headaches are triggered by physical exertion, sex, coughing, or sneezing.

If you need imaging tests, you may have a:

• Computed tomography scan (CT scan) of the head. A CT produces detailed pictures of structures inside the body. It can also detect serious but uncommon medical problems such as brain tumors.
• Magnetic resonance imaging (MRI) of the head. An MRI can detect changes in the normal structure of your brain. It may be ordered to rule out other serious medical problems such as brain tumors, blood clots, or a bulge in the wall of a blood vessel (aneurysm). But most headaches are not caused by these more serious conditions.

Talking with your doctor may help you decide whether to have imaging tests to evaluate your headaches. For more information on this decision, see:

Should I have imaging tests to evaluate my headaches?

If your symptoms are not clearly related to cluster headaches, your doctor may order additional tests such as blood or urine tests to rule out other causes.

Treatment Overview

There is no cure for cluster headaches, but treatment can effectively reduce the frequency and severity of your headaches. You don't have to live with the excruciating pain of these headaches. Treatment depends on the frequency of headache cycles and the severity of symptoms during a cycle.

Initial treatment

Treatments to stop cluster headaches that have already started are called abortive headache treatments. They include abortive headache medicines and oxygen therapy. Abortive treatments relieve pain and reduce the severity of symptoms after the headaches begin. Abortive headache treatments used most often to stop a cluster headache include:

• Ergotamine preparations, such as ergotamine tartrate with caffeine (such as Cafergot), which narrow blood vessels to relieve pressure and reduce headache pain.
• High-flow oxygen inhalation therapy, in which you breathe oxygen through a face mask to reduce blood flow to the brain and relieve headache pain. Around 7 out of 10 people treated with oxygen soon after the start of a headache get relief within 10 to 20 minutes.² But you need to repeat the treatment when the next headache begins.
• Intranasal lidocaine, which is taken by nose drops to stop severe headache pain.
• Triptans (Imitrex, Zomig), which can be injected to reduce pressure and pain. These medicines can also be taken by mouth as a pill or sprayed in the nose.

Medicines used to prevent cluster headaches or reduce the number of headaches in a cycle are called prophylactic headache medicines. Prophylactic headache medicines most often used to prevent cluster headaches include:

• Calcium channel blockers, such as verapamil hydrochloride (Calan, Verelan). These are used to prevent or reduce the number of headaches in a cluster period. Verapamil hydrochloride is commonly used for preventing both occasional and chronic cluster headaches.
• Lithium. Lithium carbonate (Eskalith, Lithobid) is thought to affect the brain's biological clock (hypothalamus), which some experts think is linked to cluster headaches, although the specific problem or abnormality that triggers cluster headaches is unclear. Lithium is often prescribed to prevent chronic cluster headaches.
• Antiseizure medicines, such as divalproex sodium (Depakote), valproate (Depacon), valproic acid (Depakene), or topiramate (Topamax). These may be tried if other treatments are not effective.

Corticosteroids, such as prednisone. These medicines are used to stop cluster headaches for a short time. These medicines give you some relief from headaches while preventive medicines start to work. This type of medicine is called a transitional medicine. Corticosteroids are not used as preventive medicines long term because of bad side effects.

It may be helpful to identify and avoid headache triggers such as alcohol, cigarettes, and raising your body temperature with hot baths or exercise during a headache cycle. For more information, see:

Headaches: Managing headaches.

Keep track of when your cluster headaches happen, how often they happen, how severe your symptoms are, and what you think may be causing the headaches. Write it all down in a headache diary (What is a PDF document?) . Take this written record with you when you visit your doctor, because it can provide valuable information to guide your treatment.

Headaches sometimes require imaging tests, but it is rare that headaches are the only symptom of a brain tumor. If your symptoms do not clearly indicate cluster headaches, your doctor may recommend imaging tests (such as a CT scan or an MRI) to rule out other possible causes of the headaches. Talking with your doctor can help you decide whether imaging tests are right for you. For more information, see:

Should I have imaging tests to evaluate my headaches?

Ongoing treatment

Ongoing treatment for cluster headaches usually includes taking prescribed medicines and avoiding headache triggers. It may take several attempts with different medicines before you find the right one. If a medicine is not preventing or stopping your headaches, talk with your doctor to see whether another medicine or a combination of medicines might work better.

Abortive headache treatments are often used to stop a headache after a cycle of cluster headaches begins. Those most often prescribed include:

• Ergotamine preparations, such as ergotamine tartrate with caffeine (such as Cafergot), which narrow blood vessels to relieve pressure and reduce headache pain.
• High-flow oxygen inhalation therapy, in which you breathe oxygen through a face mask to reduce blood flow to the brain and relieve headache pain. Around 7 in 10 people treated with oxygen soon after the start of a headache get relief within 10 to 20 minutes.² But you need to repeat the treatment when the next headache begins.
• Intranasal lidocaine, which is taken by nose drops to stop severe headache pain.
• Triptans (Imitrex, Zomig), which can be injected to reduce pressure and pain. These medicines can also be taken by mouth as a pill or sprayed in the nose.

If your cluster headaches come back often or become chronic, you may want to consider taking a prophylactic headache medicine to limit the number of headaches you get during a cycle. These medicines can also make your headaches less severe. Prophylactic medicines most often used to prevent headaches include:

• Calcium channel blockers, such as verapamil hydrochloride (Calan, Verelan). These are used to prevent or reduce the number of headaches in a cluster period. Verapamil hydrochloride is commonly used for preventing both occasional and chronic cluster headaches.
• Lithium. Lithium carbonate (Eskalith, Lithobid) is thought to affect the brain's biological clock (hypothalamus), which some experts think is linked to cluster headaches, although the specific problem or abnormality that triggers cluster headaches is unclear. Lithium is often prescribed to prevent chronic cluster headaches.
• Antiseizure medicines, such as divalproex sodium (Depakote), valproate (Depacon), valproic acid (Depakene), or topiramate (Topamax). These may be tried if other treatments are not effective.

Corticosteroids, such as prednisone. These medicines are used to stop cluster headaches for a short time. These medicines give you some relief from headaches while preventive medicines start to work. This type of medicine is called a transitional medicine. Corticosteroids are not used as preventive medicines long term because of bad side effects.

Identifying and avoiding headache triggers is another way to help prevent or reduce the number of recurring cluster headaches during a cycle of headaches. Avoiding alcohol, cigarettes, and certain foods (such as aged cheeses and processed meats) may help reduce the number of headaches you have during a cycle. For more information, see:

Headaches: Managing headaches.

Keep track of when your cluster headaches happen, how often they happen, how severe your symptoms are, and what you think may be causing the headaches. Write it all down in a headache diary (What is a PDF document?) . Take this written record with you when you visit your doctor, because it can provide valuable information to guide your treatment.

If your headaches are not relieved by medicines or their pattern changes, your doctor may recommend imaging tests to rule out other causes of your headaches. Talking with your doctor can help you decide whether imaging tests are right for you. For more information, see:

Should I have imaging tests to evaluate my headaches?

Chronic, excruciating, and debilitating cluster headaches can cause depression. If your headaches are so painful you feel depressed, talk to your doctor. Knowing the severity of your symptoms will help your doctor prescribe the best treatment.

Treatment if the condition gets worse

If your cluster headaches get worse, change their pattern, or become chronic, you may want to talk to your doctor about different treatments. By keeping a headache diary (What is a PDF document?) , you can help identify the pattern of your headaches so you become aware of any changes and can discuss them with your doctor.

Sometimes changing medicines is all that is needed. It is possible you may need to try a prophylactic medicine to prevent headaches rather than an abortive medicine to stop the headaches as they occur.

If your headaches are severe or frequent, you may want to ask your doctor about trying high-flow oxygen inhalation therapy. Breathing in 100% oxygen through a face mask soon after a headache begins can eliminate or greatly reduce pain for many people within 10 to 20 minutes. But the procedure must be repeated when the next headache in the cycle of headaches begins. Oxygen therapy is helpful for many people, but it is not effective for everyone.

If your headache pattern changes, headaches become worse, or are not helped with medicines, your doctor may recommend imaging tests to rule out other causes of your headaches. Talking with your doctor can help you decide whether imaging tests are right for you. For more information, see:

Should I have imaging tests to evaluate my headaches?

Other rare treatment

Surgery and radiation may be considered after other medical treatments have failed to improve cluster headaches. Because surgery and radiation can cause significant, destructive changes in the brain, these treatments are rarely used. Further study on surgery and radiation therapy for the treatment of cluster headaches is needed to prove any effectiveness.³

What To Think About

You may need to try several different medicines or a combination of medicines before finding the most effective treatment. If your headaches occur infrequently, you may only need to take medicines as the headaches begin. If your headaches occur regularly, you may need to take medicines daily during a cluster period to prevent a future headache or reduce the number of headaches in a cycle.

Prevention

Currently, there is no way to prevent cluster headaches from developing, because their cause is unclear. There are medicines that can lower the number of cluster headaches you get in a cycle. Other medicines can shorten the time you have the headaches.

But when you are having a cycle of headaches, identifying and avoiding headache triggers may reduce the severity and duration of the headaches. Common cluster headache triggers include:

• Alcohol.
• Irregular sleep patterns. Changes in your normal sleep patterns (especially taking afternoon naps) seem to trigger cluster headaches.
• Smoking cigarettes.
• Stress. Some people develop headaches after a stressful event is over. Reduce stress to prevent headaches with activities such as regular exercise. For more information, see the topic Stress Management.
• Certain foods, such as aged cheeses (bleu cheese, for example) and processed meats (bacon, for example).
• Raised body temperature. This can happen during exercise or if you take a hot bath.

Home Treatment

The excruciating pain from cluster headaches can be debilitating. Identifying and avoiding triggers (such as alcohol or smoking) can reduce the severity and duration of headache cycles.

You can manage your headaches at home by:

• Using high-flow oxygen inhalation therapy, which is inhaled through a loose face mask and for many people can relieve headache pain within 10 to 20 minutes.
• Taking the proper dose of medicine when the first headache starts.
• Taking your preventive headache medicine daily as prescribed.
• Keeping track of when your cluster headaches happen, how often they happen, how severe your symptoms are, and what you think may be causing the headaches. Write it all down in a headache diary (What is a PDF document?) . Take this written record with you when you visit your doctor, because it can provide valuable information to guide your treatment.

Learning to effectively manage headaches at home may help reduce the severity and duration of the headache cycles. For more information, see:

Headaches: Managing headaches.

If your headaches become more severe and medicines are not working, let your doctor know. You may need to try a different medicine or a combination of medicines. You may also need to be referred to a hospital or headache clinic for more intensive treatment.

Chronic cluster headaches can lead to stress and depression, which in turn can continue the headache cycle. Finding ways to cope with stress (such as with regular exercise) and improve depression may reduce the severity or frequency of your cluster headaches.

If your cluster headaches tend to start during sleep, you may find yourself trying to stay awake to avoid getting another cluster headache. But regular sleep helps you prevent cluster headaches. If you are trying to stay awake or not getting good sleep because of your fear of cluster headaches, talk to your doctor about your options. You may be able to take a medicine before you go to sleep that can help prevent headaches.

Medications

Medicines may stop a cluster headache after it starts and prevent additional headaches from occurring. Finding the right medicine can take some time. You may need a combination of medicines to effectively treat your cluster headaches.

Medication Choices

Treatments used to stop cluster headaches are called abortive headache treatments and most often include:

• Ergotamine preparations, such as ergotamine tartrate with caffeine (such as Cafergot), which narrow blood vessels to relieve pressure and reduce headache pain.
• High-flow oxygen inhalation therapy, in which you breathe oxygen through a face mask to reduce blood flow to the brain and relieve headache pain. Around 7 out of 10 people treated with oxygen soon after the start of a headache get relief within 10 to 20 minutes.² But you need to repeat the treatment when the next headache begins.
• Intranasal lidocaine, which is taken by nose drops to stop severe headache pain.
• Triptans (Imitrex, Zomig), which can be injected to reduce pressure and pain. These medicines can also be taken by mouth as a pill or sprayed in the nose.

Medicines that prevent cluster headaches during a cluster period are called prophylactic headache medicines. You must take these medicines every day during a cycle of headaches, even on days when you do not get a headache. They include:

• Calcium channel blockers, such as verapamil hydrochloride (Calan, Verelan). These medicines are used to prevent cluster headaches or reduce the number of headaches in a cluster period. Verapamil hydrochloride is commonly used for preventing both occasional and chronic cluster headaches.
• Lithium. Lithium carbonate (Eskalith, Lithobid) is thought to affect the brain's biological clock (hypothalamus), which some experts think is linked to cluster headaches, although the specific problem or abnormality that triggers cluster headaches is unclear. Lithium is often prescribed to prevent chronic cluster headaches.
• Antiseizure medicines, such as divalproex sodium (Depakote), valproate (Depacon), valproic acid (Depakene), or topiramate (Topamax). These may be tried if other treatments are not effective.

Corticosteroids, such as prednisone. These medicines are used to stop cluster headaches for a short time. These medicines give you some relief from headaches while preventive medicines start to work. This type of medicine is called a transitional medicine. Corticosteroids are not used as preventive medicines long term because of bad side effects.

What To Think About

Over-the-counter pain medicines, such as aspirin, acetaminophen, and ibuprofen, usually do not relieve the severe pain of cluster headaches. Also, prescription narcotic pain medicines are not recommended for cluster headaches. Such prescription medicines that are not recommended include hydrocodone bitartrate and acetaminophen (Vicodin), propoxyphene napsylate and acetaminophen (Darvocet), oxycodone hydrochloride (OxyContin), oxycodone hydrochloride and acetaminophen (Percocet), and morphine.

When a cluster headache occurs, it is important to use as early as possible the medicine your doctor has recommended. The sooner you treat the headache, the less painful it may be.

The choice of medicine may depend on the time of day when your headaches tend to occur. Some people may need a combination of 2 or 3 medicines. Keeping track of your symptoms can help your doctor determine the proper medicine. You can keep track by using a headache diary (What is a PDF document?) .

The U.S. Food and Drug Administration (FDA) has issued a warning on antiseizure medicines and the risk of suicide and suicidal thoughts. The FDA does not recommend that people stop using these medicines. Instead, people who take antiseizure medicine should be watched closely for warning signs of suicide. People who take antiseizure medicine and who are worried about this side effect should talk to a doctor.

Surgery

Surgery for cluster headaches usually involves cutting or interrupting the nerves that send pain signals to the face. Another procedure is radiation, which uses a high-intensity beam to disrupt pain signals from the trigeminal nerve, which regulates sensation to the face. But not much research exists on the long-term effectiveness of these procedures, and they are rarely done to treat cluster headaches.³

Other Treatment

While medicines may effectively control cluster headache pain or reduce the number of headaches in a cycle, another treatment to consider is high-flow oxygen inhalation therapy.

During high-flow oxygen inhalation therapy, you breathe in 100% oxygen through a face mask soon after a headache begins. Usually, the headache pain stops within 10 to 20 minutes. This therapy may prevent additional headaches in the cycle from occurring. But if another headache does occur, you will need to repeat the procedure as soon as the next headache in the cycle begins. This treatment may be more effective in people under the age of 50 who only occasionally have cluster headaches.

High-flow oxygen inhalation therapy will not prevent cluster headaches. It provides only temporary relief of headache pain. Also, you'll need an oxygen tank near you at all times for immediate treatment when a cluster headache cycle begins. Some people find this inconvenient or not possible.

Other Places To Get Help

Organizations

Related Information

• Depression
• Headaches
• Migraine Headaches
• Stress Management
• Tension Headaches

References

Citations

1. Ropper AH, Brown RH (2005). Cluster headache section of Headache and other craniofacial pains. In Adams and Victor's Principles of Neurology, 8th ed., pp. 155-157. New York: McGraw-Hill.

2. Evans RW (2003). Headaches. In Saunders Manual of Neurologic Practice, pp. 25-32. Philadelphia: Saunders.

3. Capobianco DJ, Dodick DW (2006). Diagnosis and treatment of cluster headache. Seminars in Neurology, 26(2): 242-259.

Other Works Consulted

• Bahra A, et al. (2002). Cluster headache: A prospective clinical study with diagnostic implications. Neurology, 58(3): 354-361.

• Diamond S (2007). Migraine headaches. Diagnosing and Managing Headaches, 5th ed., pp. 55-115. Caddo, OK: Professional Communications.

• Raskin NH, Green MW (2005). Cluster headache section of Migraine and other headaches. In LP Rowland, ed., Merritt's Neurology, 11th ed., pp. 986-987. Philadelphia: Lippincott Williams and Wilkins.

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