Cluster headache: pathophysiology, diagnosis and treatment

Area of Science:

• Neurology
• Headache Medicine

Background:

• Cluster headache (CH) is a debilitating neurovascular and chronobiologic disorder.
• Characterized by severe unilateral orbital, supraorbital, or temporal pain with ipsilateral autonomic symptoms and agitation.
• Pathophysiology remains incompletely understood, implicating central brain mechanisms.

Purpose of the Study:

• To review the diagnosis and therapy of cluster headache.
• To highlight challenges in timely diagnosis and treatment initiation.

Main Methods:

• Review of clinical features of cluster headache attacks.
• Emphasis on diagnostic criteria including pain characteristics and autonomic phenomena.
• Discussion of current and alternative therapeutic interventions.

Main Results:

• Diagnosis is primarily based on clinical history and characteristic attack patterns.
• Effective management involves abortive and preventive therapies.
• Despite advances, significant diagnostic delays and misdiagnoses persist.

Conclusions:

• Accurate and timely diagnosis of cluster headache is crucial for effective management.
• Addressing diagnostic delays is essential to improve patient outcomes and timely treatment.
• Further research into pathophysiology may improve therapeutic strategies.