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.

Comparison chart

Cluster Headache versus Migraine comparison chart
Edit this comparison chartCluster HeadacheMigraine
Characteristics of pain Stabbing pain Deep throbbing and pulsating pain
Location of pain Pain located near the eye on affected side. Usually unilateral. Deep stabbing pain around the temple or the eye.
Gender predominance More common in men More common in women
Sensitivity to light or sound Rare Typical
Runny nose and red, watery eyes Present Rare
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 hours
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

Signs and symptoms:

Cluster Headaches


Pain and Other symptoms


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.


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


Cluster Headaches


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


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":


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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