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Stereotactic Radiosurgery for Cluster Headache: A Single Center Retrospective Study
David Mathieu1, Andréanne Hamel, Louis Carrier
1Division of Neurosurgery, Centre de recherche du CHUS, Université de Sherbrooke, Sherbrooke , Quebec , Canada.
Neurosurgery
|September 11, 2025
Summary
Stereotactic radiosurgery (SRS) offers transient pain relief for refractory cluster headache (CH) in most patients. While effective for recurrence, bothersome numbness rates may be lower than previously reported after initial SRS treatment.
Area of Science:
- Neurosurgery
- Neurology
- Pain Management
Background:
- Cluster headache (CH) is a rare, severe primary headache disorder.
- Medically refractory cases often require advanced treatment options.
- Stereotactic radiosurgery (SRS) is an emerging therapy for intractable CH.
Purpose of the Study:
- To evaluate the efficacy of SRS in managing refractory cluster headache.
- To assess pain relief duration, recurrence rates, and sensory complications following SRS.
- To determine the long-term outcomes of SRS for cluster headache patients.
Main Methods:
- Retrospective analysis of 18 patients undergoing SRS for CH (2004-2022).
- Collection of pre-treatment demographics, symptoms, and pain characteristics.
- Follow-up assessment of symptom evolution and complications, analyzed using Kaplan-Meier and descriptive statistics.
Main Results:
- 79% of patients achieved adequate pain control (modified Barrow Neurological Institute IIIb or better) after a median of 4 months.
- Pain recurrence was observed in 80% of patients after a median of 27 months.
- New bothersome facial numbness occurred in 16% after primary SRS and 50% after repeat SRS.
Conclusions:
- SRS is a viable management option for refractory cluster headache, providing transient pain relief.
- Recurrence of pain is common, but repeat SRS can be effective.
- The incidence of bothersome numbness after a single SRS procedure appears lower than previously reported.
