Related Experiment Video
Updated: Jun 6, 2026
10:39
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Management of chronic cluster headache
Massimo Leone1, Angelo Franzini, Alberto Proietti Cecchini
1Pain Neuromodulation Unit, Department of Neurology, Headache Center, Carlo Besta Neurological Institute Foundation, Via Celoria 11, 20133, Milano, Italy, leone@istituto-besta.it.
Current Treatment Options in Neurology
|November 26, 2010
Summary
Cluster headache (CH) treatments include sumatriptan or oxygen for acute attacks. For chronic CH prevention, verapamil and lithium are recommended first-line, with steroids reserved for refractory cases, and neurostimulation as a last resort.
Area of Science:
- Neurology
- Pain Management
Background:
- Cluster headache (CH) is a debilitating neurological disorder characterized by severe head pain.
- Limited high-quality clinical trials exist for many CH treatments, especially preventive therapies.
- Evidence quality for existing pharmacologic agents in CH management is often suboptimal.
Purpose of the Study:
- To provide evidence-based recommendations for the management of primary cluster headache.
- To evaluate the efficacy and safety of various abortive and preventive treatment options for CH.
- To guide clinical decision-making for refractory chronic cluster headache cases.
Main Methods:
- Review of existing clinical trial data and expert opinion on CH pharmacologic treatments.
- Assessment of evidence quality (Class I, II) for abortive and preventive therapies.
- Evaluation of neurostimulation techniques, including occipital nerve stimulation and hypothalamic stimulation, for refractory CH.
Main Results:
- Sumatriptan and oxygen are recommended for aborting acute CH attacks (Class I evidence).
- Verapamil and lithium are considered first-line preventive treatments for chronic CH (Class II evidence).
- Steroids are effective preventives but recommended only when other treatments fail due to adverse effects; neurostimulation is an option for refractory cases.
Conclusions:
- Current evidence supports specific abortive and preventive strategies for CH, though data quality varies.
- Verapamil, lithium, and neurostimulation (occipital nerve or hypothalamic) represent key options for chronic CH management.
- Careful consideration of treatment risks and benefits is essential, particularly with long-term steroid use and invasive procedures.
Related Concept Videos
01:29Chronic Obstructive Pulmonary Disease-V: Management
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
01:29Chronic Pancreatitis II: Collaborative Care
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
01:19Management of Insomnia
The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
01:24Cystic Fibrosis: Management
Cystic fibrosis (CF) is an autosomal recessive disorder that predominantly affects individuals of Northern European descent, occurring at a rate of 1 in 3500. It is caused by a genetic mutation in a gene on chromosome 7, most commonly the ΔF508 mutation, that codes for the cystic fibrosis transmembrane conductance regulator (CFTR) protein. This results in thicker mucus secretions and obstruction pathologies in multiple organs, including the lungs and sinuses.
Sinus disease and chronic sinusitis...
Sinus disease and chronic sinusitis...
01:23Hypertension V: Nursing Management
The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
Nursing management of Chronic Obstructive Pulmonary Disease (COPD) is crucial for providing thorough care and support to patients. Nurses play an integral role in this process through detailed assessment, careful planning, targeted interventions, and ongoing evaluation. Here's an overview of the critical steps in nursing management for COPD.
Assessment
Assessment