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Cluster headache

Cephalea histaminica (cluster headache) · Clusterová (Hortonova) bolest hlavy

What it is

Strictly one-sided attacks of extreme pain in daily clusters — 'suicide headache'.

Symptoms & signs

  • Stabbing pain behind one eye
  • tearing
  • nasal blockage
  • restlessness
  • 15–180 min, often at night

🚩 Get help if…

  • call 112 / 911 now Headache with weakness, confusion or loss of consciousness
  • call 112 / 911 now Sudden worst-ever headache unlike your usual attacks
  • see a doctor soon First attacks ever — they need a scan and a specialist
  • see a doctor soon Thoughts of suicide during a cluster

Where it strikes

Medical treatment

  • High-flow oxygen 12–15 L/min
  • sumatriptan injection
  • verapamil prevention
  • greater occipital nerve block
  • galcanezumab
  • non-invasive vagus stimulation (gammaCore) — FDA-cleared 2017–18; helped episodic, not chronic, cluster headache in trials

Natural & lifestyle

  • Strict sleep schedule
  • no alcohol during a cluster
  • melatonin 10 mg at night

Emerging & experimental

  • Sphenopalatine ganglion stimulation
  • psilocybin pulse-dosing trials

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • High-dose vitamin D regimen (Batch protocol) — a small uncontrolled study reported fewer attacks early / small studies
  • Capsaicin in the nostril on the painful side — small trials helped early / small studies
  • Energy drinks and strong coffee at onset — patients' tricks; untested anecdotal / traditional

ICD codes