Cluster headache is characterized by severe, unilateral headache attacks of orbital, supraorbital or temporal pain lasting 15–180 min accompanied by ipsilateral lacrimation, rhinorrhea and other cranial autonomic manifestations. Cluster headache attacks need fast-acting abortive agents because the pain peaks very quickly; sumatriptan injection is the gold standard acute treatment.
A great deal of studies suggests that cluster headache (CH) patients are usually comorbid to anxiety-mood spectrum disorders and psychopathological symptoms; however, the personality profiles reported in the literature strictly depend on type of assessment used. Psychiatric comorbidities have been extensively studied in migraine and they are recognized to represent a major risk factor associated with poorer outcome, playing a role in the headache chronification process at once as cause and consequence of it. By contrast the incidence and role of psychopathological aspects in CH is still not clarified, insufficiently explored as the striking severity of such a physical pain apparently leaves no room to psychological explanations.
This was an observational survey study administered to individuals over age 18 who identify themselves as having cluster headache. Patient perspectives on the use of placebo in cluster headache clinical trials were assessed using a paper-based survey. Participants were recruited during a national conference held for patients with cluster headaches (“Clusterbusters” in Austin, TX, September 2016). Informed consent was obtained and no identifiable data were collected.
Previous functional and structural imaging studies have revealed that subcortical structures play a key a role in pain processing. The recurring painful episodes might trigger maladaptive plasticity or alternatively degenerative processes that might be detected by MRI as changes in size or microstructure. In the current investigation, we aimed to identify the macro- and microstructural alterations of the subcortical structures in episodic cluster headache.
Patients with CH often require a multimodal treatment approach during cluster periods using acute, transitional, and prophylactic therapy. Transitional therapies are useful in treating high frequency cluster headache attacks while prophylactic medication dosages are increased. However, there is limited data comparing the efficacy of oral versus injected transitional treatments.
Chronic Cluster Headache (CCH) is the most severe and disabling primary headache. Studies using functional magnetic resonance imaging showed the ipsilateral posterior hypothalamus activation during the cluster headache episodes. The Deep Brain Stimulation (DBS) of the posterior hypothalamic area was introduced in 2000 in order to treat drug-resistant chronic cluster headache.