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Updated: Jul 5, 2026

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
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Cluster headache: to scan or not to scan.

Irene Favier1, Joost Haan, Michael D Ferrari

  • 1Department of Neurology, K5-Q, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands. i.favier@lumc.nl

Current Pain and Headache Reports
|May 14, 2008
PubMed
Summary

Cluster headache (CH) can rarely be caused by structural lesions like pituitary tumors, challenging the definition of CH. Magnetic resonance imaging (MRI) is recommended for neuroimaging if suspected.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Headache Medicine

Background:

  • Cluster headache (CH) is typically defined as not having an underlying structural cause.
  • However, cases of CH or CH-like syndromes associated with structural lesions have been reported.
  • Establishing a causal link between the headache and the lesion can be challenging.

Purpose of the Study:

  • To review the literature for symptomatic CH or CH-like cases where a causal relationship with an underlying structural lesion is highly probable.
  • To investigate if structural pathologies can mimic typical cluster headache presentations.

Main Methods:

  • Retrospective review of case reports from existing literature.
  • Analysis of cases where a strong causal link between structural lesions and CH or CH-like syndromes was identified.

Main Results:

  • Even typical cluster headache (CH), characterized by episodic patterns and treatment response, can be associated with structural pathologies, such as pituitary tumors.
  • A small series of case reports suggests a potential link between structural lesions and CH symptoms.

Conclusions:

  • Underlying structural pathology should be considered in some cases presenting as cluster headache (CH) or CH-like syndromes.
  • While definitive advice on neuroimaging is difficult based on limited data, MRI is preferred over CT if imaging is pursued.
  • Further research is needed to clarify the role of structural lesions in CH.