A cluster headache is an excruciatingly painful headache on one side of the head. This type of headache usually affects men, according to the Merck Manuals. A person often experiences tearing up of the eye on the same side as the pain, along with flushing of the face and nasal congestion. Doctors prescribe different treatments for cluster headache, depending on whether the aim of treatment is to stop the attack or to prevent future attacks.
Oxygen for Acute Cluster Headache
One option for first-line treatment of a cluster headache is inhalation of pure oxygen, notes Dr. Ellen Beck in a February 2005 article published in "American Family Physician." The results of a randomized trial by Dr. Anna S. Cohen and colleagues, published in December 2009 in the "Journal of the American Medical Association," showed that oxygen resulted in elimination of pain, or at least adequate relief from pain, within 15 minutes in 78 percent of patients.
Medications for Acute Cluster Headache
Doctors may prescribe sumatriptan, a selective serotonin receptor agonist, to treat a patient with a cluster headache. Some doctors may treat patients with sumatriptan by itself; others may choose to use it in conjunction with oxygen treatment. Dr. Beck mentions dihydroergotamine and lidocaine as other prescription medications used to treat a cluster headache.
Medications for Prevention
The severe pain from a cluster headache can incapacitate some sufferers, so doctors prescribe medications to prevent future attacks. Depending on the patient and his medical condition, doctors may select from verapamil, prednisone, ergotamine, methylergonovine maleate, melatonin or one of the anti-epileptic drugs divalproex and topiramate. Some of these medications may cause adverse side effects in some patients, and patients should discuss potential side effects with their doctors before beginning treatment.
Treatment for Intractable Cluster Headache
When medications fail to eliminate cluster headaches, doctors may choose to perform a surgical procedure known as microvascular decompression, or MVD, of the fifth cranial nerve. The purpose of this is to relieve the pressure exerted by a blood vessel on that nerve. The procedure requires a craniotomy, an operation to open up the skull, in order to expose the nerve. The surgeon then inserts an implant between the nerve and the blood vessel that presses on it. Dr. Beck notes that in many patients, the effectiveness of this operation in providing relief declined within five years, and repeated operations did not help them.
References
- American Academy of Family Physicians: Management of Cluster Headache
- Medline Plus: Cluster Headache
- Journal of the American Medical Association: High-Flow Oxygen for Treatment of Cluster Headache
- International Headache Society: International Classification of Headache Disorders, 2nd Edition
- Merck Manuals: Cluster Headache
