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    Headache, Cluster

    Headache, Cluster is a topic covered in the 5-Minute Emergency Consult.

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    Basics

    Description

    • Excruciatingly painful primary headache disorder
      • Infrequent cause of ED visits and affects only 0.1% of the population
    • Often has abated by time of presentation
      • Attacks last between 15 and 180 min (75% last <60 min)
    • More common in men (∼3:1)
    • Onset usually between 30 and 50 yr of age
    • Headaches occur in clusters lasting weeks to months followed by remission >1 mo
    • Commonly occur 1–3 times per day during cluster period that lasts 2–3 mo
    • Often occur during the same time of day
    • Often occur during the same time of the year
      • Highest incidence in spring and fall
    • Chronic cluster headache:
      • Remission <1 mo
      • Do not experience remission
      • 10% of patients
    • May have many clinical and pathophysiologic similarities with migraine and variants
    • Often follows a trigeminal nerve dermatome

    Etiology

    A well-described physiologic reflex arc, the trigeminovascular reflex, potentiates the trigeminal pain and cranial autonomic features of cluster headache by positive feedback mechanisms.

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    Citation

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    TY - ELEC T1 - Headache, Cluster ID - 307059 ED - Barkin,Adam Z, ED - Barkin,Roger M, ED - Hayden,Stephen R, ED - Rosen,Peter, ED - Schaider,Jeffrey J, ED - Shayne,Philip, ED - Wolfe,Richard E, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307059/all/Headache__Cluster PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -