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Late-onset cluster headache: some considerations about 73 cases.

G C Manzoni1, M Maffezzoni, G Lambru

  • 1Headache Centre, University of Parma, Via Gramsci 14, 43100 Parma, Italy. giancamillo.manzoni@unipr.it

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|May 31, 2012
PubMed
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Cluster headache (CH) onset after age 50 is increasingly reported, particularly in women. Late-onset CH is linked to a poorer prognosis, with a higher likelihood of chronic forms and prolonged active periods.

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Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Cluster headache (CH) typically presents in early adulthood.
  • Recent literature suggests an increase in late-onset CH cases.

Observation:

  • A review of 693 CH patients revealed 10.5% experienced onset after age 50.
  • The male-to-female ratio for late-onset CH was 1.4:1, compared to 2.5:1 for earlier onset.
  • Late-onset CH showed different subtype distributions, especially in women.

Findings:

  • In men, late-onset episodic CH active periods averaged 60 days versus 39 days for early onset.
  • In women, late-onset episodic CH active periods averaged 80 days versus 42 days for early onset.
  • Late-onset CH is more prevalent in women and associated with a higher chronification rate.

Implications:

  • Onset of cluster headache after age 50 is not uncommon, particularly in women.
  • Late onset is a negative prognostic indicator for cluster headache.
  • Late-onset CH may require different management strategies due to chronicity and duration.