Cluster Headache vs. Migraine

Cluster Headache

Cluster headaches are rare, extremely painful and debilitating headaches that occur in groups or clusters. They often appear during seasonal changes. They are also described as suicide headaches, a reference to the excruciating pain and resulting desperation that has culminated in actual suicide.

A migraine is a form of vascular headache. Migraine headache is caused by a combination of vasodilatation (enlargement of blood vessels) and the release of chemicals from nerve fibers that coil around the blood vessels. During a migraine attack, the temporal artery enlarges. (The temporal artery is an artery that lies on the outside of the skull just under the skin of the temple.) Enlargement of the temporal artery stretches the nerves that coil around the artery and cause the nerves to release chemicals. The chemicals cause inflammation, pain, and further enlargement of the artery. The increasing enlargement of the artery magnifies the pain.

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Cluster Headache


Characteristics of pain Stabbing Deep throbbing and pulsating
Gender predominance More common in males More common in females
Sensitivity to light or sound Rare typical
Runny nose and red, watery eye Present rare
Location of pain Pain located near the eye on affected side. Usually unilateral. Deep stabbing pain around the temple or the eye
Severity of pain Very severe Ranging from moderate to quite severe
Time of onset Short; headaches peak within 45 minutes long, headache gradually peaks in around 4-24 hrs
Triggers Nitroglycerin (glyceryl trinitrate), hydrocarbons (petroleum solvents, perfume), Alcohol, napping, etc. Bright lights, loud noises, Changes in sleep patterns, exposure to smoke, Skipping meals etc.
Prodromal aura before headache Absent present
Nausea or vomiting Rare common
Breathing issues breathing issues through the nostril on the side of the pain rare

Contents: Cluster Headache vs Migraine

edit Signs and symptoms:

edit Cluster Headaches

edit Migraine

edit Pain and Other symptoms

edit Prevalence

While migraines are diagnosed more often in women, cluster headaches are diagnosed more often in men. The male-to-female ratio in cluster headache ranges from 4:1 to 7:1. It primarily occurs between the ages of 20 to 50 years. Tension headaches are more common in both sexes, accounting for the vast majority of headaches.

edit Genetics

First-degree relatives of sufferers are more likely to have the condition than the population at large.

edit Triggers

edit Cluster Headaches

edit Migraine

According to the National Library of Medicine's Medical Encyclopedia, Migraine attacks may be triggered by:

edit Diagnosis

The diagnosis of migraine without aura, according to the International Headache Society, can be made according to the following criteria, the "5, 4, 3, 2, 1 criteria":

edit Treatment

For less severe migraines, over-the-counter NSAIDs, such as ibuprofen or acetaminophen, may provide sufficient relief.

Triptan drugs can provide relief for both migraine sufferers and those suffering from cluster headaches. These drugs are frequently given in the form of injections or nasal sprays. Sumatriptan and zolmitriptan are commonly prescribed; zolmitripan also comes in tablet form.

Other treatments for cluster headaches include nasal spray forms of local anesthetics (e.g., lidocaine); steroids; octreotide, which mimics a brain hormone; and dihydroergotamine, which can also be used to treat migraines. Less commonly, those with cluster headaches are prescribed oxygen for use during headaches.

Migraine sufferers may also be given opioids, like codeine. Anti-nausea drugs are commonly used as well, since many sufferers experience nausea or vomiting during a migraine.

Doctors may recommend preventive treatment for migraines and cluster headaches, particularly if one has multiple episodes over short periods of time. Preventive treatment may include lifestyle or dietary changes and will often include some form of ongoing prescription medication.

Surgery is very rarely recommended for these health problems, as there is not enough evidence yet to suggest that surgery provides relief over time.

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Comments: Cluster Headache vs Migraine

Anonymous comments (13)

July 24, 2013, 6:41am

It really shocks me that so many people get both migraines and clusters. Man that must be the ultimate in totally medieval gruesome pain. I mean how the heck do you survive that??? I've never had a migraine, but my mother had them for many years and she really suffered. I can tell you the difference between the two is like night and day, black and white, oil and water. Even though I've never had a migraine I can tell you clusters are far, far worse. A few months ago I was diagnosed in the e-room with clusters. For me the first time the pain was so incredibly intense I thought for sure, knew for sure, I was dying from a brain tumor or something and called 911. When the EMT's showed up I was in so much pain it through of my EKG enough for them to suspect that I was having a heart attack and sped me off to the hospital. I'm no stranger to intense pain. I've broke my back twice and have had 15 operations for that alone. I've been in anaphalactic shock so bad from a sulfa allergy they had to jump start my heart in the hospital 14 times in 24 hours. I smashed my right hand once in a fork-truck accident years ago and broke 17 bones and severed all the main tendons. All four fingers were dangling by nothing but a little flesh. All that hurt like he** but was a picnic compared to clusters.
Later at the hospital after a treadmill test my heart was in good shape. They also did a CT scan on my head which was negative for anything. No tumors.
Imagine if someone took a huge, dull, rusty battle axe and just chopped you right in the side of your head, and your eye, cheekbone, jaw, and teethe just exploded from your body and then someone began digging your brains out with a spoon through your ear. You don't feel like your going to die, you know for sure, you are certain of it. And then when you don't it takes all of about 5 minutes for you to pray that you will, and quickly. At least that's what my experience is like so far. In the e-room at the hospital I was given intravenous shots of morphine, dilaudid, and a couple others I don't remember for sure right in my IV. Sumatriptan tablets, vaporil (not sure on spelling). All of it did nothing at all. The one and only thing for me that works about half the time is oxygen at 8-10 liters a minute at the onset of a shadow for 10 to 15 minutes. It didn't make them go away at all but sometimes it seemed to decrease the intensity of the attack. But only about half the time. My attacks are usually 1-4 a day so far and almost always in the early morning hours like between 2:00am to maybe 10 or 11:00am and very occasionally I have one in the afternoon. I totally understand why some doctors have nicknamed them suicide headaches. I've considered it many times in the last 2 months. Even have it all planned out. To be perfectly honest I think the only reason I have not is because when it happens I don't have the strength physically, my thought processes get all confused, and I loose motor control and sometimes have seizures. And by the time it finally starts to subside I'm left terrified at what I was just about to do. If you really do have cluster headaches ( I suspect many on this forum who claim to be are not and their doctor is in error) then I feel for you. Just my experience and opinion, not at all trying to offend anyone. Cluster headaches are deadly and that's a fact. -Marko-

— 71.✗.✗.6

May 13, 2014, 9:10am

Anyone suffers cluster daily this is most worse pain on head.

— 123.✗.✗.183

March 21, 2014, 11:54pm

Ive had cluster headaches for 25 years now. I was diagnosed at 13. My mother has them and my oldest son was diagnosed at the age of 9. Nothing can stop the pain once it starts. Ive been to hospital many times with them. I really wish someone would cut off my head to make the pain go away while im having one. They wake me up at 4am within minitues it goes from pain to hell. My cycle is different than some. I will go 4 years with them every 6 weeks and than 4 years without a single one. Yes my teeth, jaw and eye are in severe pain along with the someone is stabbing you in side of your head behind the eye pain. I also get a stiff neck and runny nose. After a headache I feel extremely tired and just want to sleep, im not with it. Being a females makes it even more rare for me.

— 71.✗.✗.139

September 10, 2013, 9:06am

Finally here i am at 4:47am my attacks have just subsided 3 tonight, not bad considering this week it's been 4-5 a night....Freddie Kruger nightmare isn't even the word for this. I've exhausted 2 of my imitrex's and slept on my O2 my doctor even has me on a high and long dose of prednisone...but the beast came knocking again like he has all week at 2:26am and I have not been back to bed yet. I'm exhausted, physically drained, and yet in 2 hours I have to get my special needs son to school and get to work for meetings and appointments.

my father got these headaches, I never witnessed his ritual, however, he has seen mine. He was on the front lines in the Marines overseas in one of the wars. Tough as nails he was, i suppose as the marines taught him to be. He was a great father and I I have never really seen my father as upset as that night when he looked at my face and tried to help, but deep down, he knew there was nothing he could do except wait, and watch me pace, scream, bang my head. right now i have finally stopped the pacing, my face is sore and my teeth are obviously present (meaning i feel every blood vessel throbbing).

I have tried melatonin, however, it wasn't helpful, tried it for 2 months, bottle sits in a drawer, i've tried magnesium as suggested by others, to no avail, another bottle sitting in a drawer.

there is a post below, a man, who broke his back and has been hurt physically and yet he would rather have that than the headaches. I don't know who you are or your name, but I understand your pain. I dropped a drill on my pinkie toe, almost losing it, shattering it, and yet THAT was better than these headaches. I didn't even need pain medication for the toe, but for these headaches, nothing touches it.

I feel for my fellow sufferers, hang in there. It's funny, I had a woman doctor ask me (who did not have clusters) so, you just had a child, was it natural child birth or did you recieve medicine? I told her it was all natural, not a thing was given (birth happened so fast there was no choice even if I wanted any) and then I asked her why she wanted to know. She asked me, which was worse, the natural child birth or the cluster? I answered her in a heartbeat and told her, the cluster hands down.

— 71.✗.✗.35

August 28, 2013, 9:20pm

I suffered Beast attacks on a regular basis from age 14 until I started taking Adderall for a completly unrelated diagnosis of adult ADD. For almost a week after I started I had a single medium CH each morning when I woke up, after that I stopped having them completely. Went from a six-three month on/off cycle of 6-8 attacks a day to having none. Been CH free for almost two years. Not even a twinge. Maybe it has something to with the effect on my dopamine levels. I also no longer have problems going to sleep, sleeping too hard, or getting frustrated, which for me was a sure way to have one. Hope this helps.

— 98.✗.✗.101

January 15, 2013, 10:57pm

Honestly, I have both of these headaches and all the other types too. Recently, I have been having issues with both clusters and headaches. Also, I am playing with the triptan class of drugs (i.e. sumatripatan or Imitrex) and have been through most of the drugs in this class. My neuro want give me topamax because I get my headaches in clusters that occur sporadically (like a cycle) every 6 months and last 1-1.5 months and go away. So far Imitrex seem to help some when I catch it early enough but it's not that great either. I tried the needless one and it seemed more potent but then switched to the needle Imitrex. I think my body got use to it rather quickly. I hate having these left-sided, pulsating, headaches. Anyone who says OTCs help haven't had a real migraine/cluster headache before. I wish there was an easier way to treat these headaches. Like the other commenter, I believe the preservatives in the food may cause these issues + headaches run on my dad side. It's amazing that my younger brother and I both suffer from these types of headaches and we're both right-handed. LOL. All seriousness, I could drill a hole in my head and it would feel better. I am currently having headaches now since last week.

— 97.✗.✗.66

December 18, 2012, 2:37pm

I have been experiencing cluster head ache last seven years. It's terrible and the pain just kill me. I wish if I had a cure from this pain. Every year the pain is getting worse. I feel like someone stabbed in my eye and head..... I fee like dying,,,,,,,,or I wish during the attack. Suggest me if you know something better....thanks

— 58.✗.✗.111

February 14, 2012, 4:57am

I take topiramate for my clusters which is primarily for epilepsy and I have been cluster free now for 2 years. I know the pain is unbearable. Every night 45 min of hell but the shots were amazing and fast. Just bloody expensive. At least the spells only lasted 2 months and they were gone as fast as they came. I wish you all well. Stay cool and push hard on your inner foot even ice them it really does help. Try not to knock youse of out. Good luck to all. Booze does not help either. Stay hydrated.

— 207.✗.✗.178

January 26, 2012, 6:59pm

My fiance also suffers from cluster headaches believed to have come from epilepsy,but oxygen DOES NOT work for him.He's been on hundreds of medications that didn't work,and the only thing that works for him is methadone from his pain doctor.

— 173.✗.✗.133

November 21, 2011, 2:51am

Can migraine also cause a watery eye and runny nose?

— 134.✗.✗.160

November 15, 2011, 5:34pm

There have been some studies about the health impacts of daylight savings time switching. Our bodies sometimes have difficulty in adjusting, which manifests itself in the form of headaches or migraines.

Here is an interesting study about the correlation (not causation) between daylight savings and suicide rates:

— 67.✗.✗.66

November 15, 2011, 2:58pm

I have cluster headaches and my insurance will not pay for the oxygen so I use the shot, it works rather quickly. This is the first year I have had a cluster episode with the time change, why?

— 173.✗.✗.75

September 20, 2011, 11:53pm

I get Cluster Headaches, but have been able to get real relief from oxygen. Breathing in oxygen from a tank at 8 liters ---just as soon as I feel a headache coming on can stop it within 5-10 minutes. And anyone who gets Clusters will tell you, that's about all the time you've got, before the pain is unbearable.

— 75.✗.✗.20


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Migraine vs. Tension Headache