Forecast
Often the disease is chronic and no causal therapy is possible. In rare cases, however, the disease comes to a spontaneous standstill. Cluster headache is still under investigation because not all questions regarding its development and treatment options have been clarified. At this stage, cluster headache cannot be cured, but it is possible to achieve good prophylaxis with modern drugs, so that it occurs rarely, if at all. If, despite the medication, there is no satisfactory reduction in the attacks, it is possible to resort to blocking the painful nerve, which only has to be done very rarely.
Diagnostics
It is important that the patient’s medical history (anamnesis) is taken and the pain characteristics are precisely recorded. A neurological examination in the interval shows no abnormalities, in the pain attack the above mentioned accompanying symptoms can be found: Swelling and drooping of the eyelids, runny nose, redness and tears of the eye and sweating on the same side where the headache appears. If necessary, further diagnostic measures must be initiated to exclude underlying diseases. The search for space-occupying processes in the head can be carried out, e.g. by taking an X-ray or computer tomography of the head.
Exclusionary diseases (differential diagnoses)
Causes of symptomatic headache include intracranial hypertension and space-occupying processes in the skull and may need to be ruled out by monitoring the ocular fundus or imaging procedures such as x-rays or computed tomography (CT). A similar localisation of pain is also found in glaucoma, so that an ophthalmological examination may be advisable. Inflammation in the region of the paranasal sinuses (see paranasal sinus inflammation) can also lead to pain in the eye-front-sleep region. Furthermore, it is not always easy to differentiate between the various forms of recurrent headache. For example, migraine, trigeminal neuralgia or hemicrania continua (hemiplegic headache) may clinically overlap with cluster headache.
How often does cluster headache occur?
Cluster headaches affect about 90/100000 people, men more often than women. Usually the headache attacks begin around the age of 30.
