Cluster headaches cause sudden, severe pain on one side of the head. The pain typically lasts for about 30 to 45 minutes. During a headache period, the patient experiences one to four headaches a day for several weeks or months, according to the National Institutes of Health. When the cycle stops, months or years may pass before the cluster headaches start again. There is no cure for cluster headaches but medication and lifestyle changes can manage the pain and prevent future attacks.
Trigger Avoidance
Diet and lifestyle changes can be helpful in preventing or reducing cluster headaches, according to the Mayo Clinic. Alcohol, tobacco, solvents, oil-based paints and gasoline can trigger cluster headaches and should be avoided. The nitrates in smoked and processed meats as well as certain medications can act as triggers in some patients, and avoiding them reduces the likelihood of cluster headaches. Getting plenty of sleep also can be helpful.
Oxygen Therapy
Breathing 100 percent oxygen with a facial mask at the first sign of a cluster headache can effectively stop an attack within 15 minutes, notes the National Headache Foundation. Oxygen therapy is a safe, low-cost remedy, but some people find it inconvenient to keep an oxygen cylinder and mask close at hand, according to the Mayo Clinic.
Medications for Acute Attacks
Several medications are available to treat the pain of an acute cluster headache, but they must be taken as soon as the attack begins. Injectable sumatriptan, often prescribed for migraines, is an effective treatment for cluster headaches as well, but it is not recommended for patients with high blood pressure or coronary artery disease, according to the Mayo Clinic. Octreotide, an injectable synthetic version of the brain hormone somatostatin, is suitable for patients who cannot tolerate sumatriptan. Dihydroergotamine or DHE is available in injectable, inhaler and intravenous forms. Nasal drops of a local anesthetic, such as lidocaine, also can be used to treat cluster headaches.
Preventive Medications
Preventive therapy is an important component of the treatment regimen, according to the Merck Manual. Combinations of short-acting and long-acting drugs, including prednisone, verapamil, lithium, topiramate or divalproex, can help prevent attacks. Alternatively, a health care provider may inject a local anesthetic and corticosteroid into the occipital nerve at the back the head to disrupt pain messages from the brain, notes the Mayo Clinic.
Surgery
Surgery can be an alternative for patients whose symptoms do not respond to medication, although it is rarely used, reports the Mayo Clinic. In the conventional surgical procedure, the surgeon destroys part of the trigeminal nerve to block pain messages. This procedure can cause complications to the eyes and is appropriate only for patients with single-sided headaches. The more common approach is to inject glycerol into the facial nerves.
