Tension headaches account for nearly 90% of all headaches and are probably experiences by most people at some time during their lifetime. Tension headaches are frequently associated with fatigue, stress or hangovers. They generally respond to simple measures such as rest or over-the-counter pain medicine. A characteristic of tension headaches is that pain usually occurs on both sides of head and is in the form of a dull, steady ache.

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 sometimes culminated in actual suicide.

Comparison chart

Cluster Headache versus Tension Headache comparison chart
Edit this comparison chartCluster HeadacheTension Headache
Characteristics of pain Stabbing pain Dull and pressure-like pain in the head. It may also produce a feeling of pressure similar to the sensation caused by the placement of a vice or a tight band on the head and/or around the neck.
Gender predominance More common in men More common in females
Sensitivity to light or sound Rare Rare
Location of pain Pain located near the eye on affected side. Usually unilateral. The pain is typically generalized, with areas of more intense pain in the scalp, forehead, temples or the back of the neck. Usually bilateral.
Severity of pain Very severe Mild to moderate in severity
Time of onset Short; headaches peak within 45 minutes Pain develops gradually, fluctuates in severity and then can remain for several days
Triggers Nitroglycerin (glyceryl trinitrate), hydrocarbons (petroleum solvents, perfume), Alcohol, napping etc. Stress
Prodromal aura before headache Absent Absent
Nausea or vomiting Rare Rare

Signs and Symptoms :

Tension-type headache

Cluster Headaches


Women are more likely to be diagnosed with tension headaches, while men are more likely to be diagnosed with cluster headaches. These headaches primarily occur between the ages of 20 to 50 years. Both cluster and tension headaches are more common than the more severe migraine.


Tension Headaches

Cluster Headaches


Tension headaches

By clinical signs and symptoms

Lab Studies:

Cluster headache:

Neurologic examination.

A neurologic examination may help your doctor detect physical signs of a cluster headache. Sometimes the pupil of your eye may appear smaller or your eyelid may droop, even between attacks.

Imaging tests.

If you have unusual or complicated headaches or an abnormal neurologic exam, you may undergo other diagnostic testing to rule out other serious causes of head pain, such as a tumor or aneurysm. Two common brain-imaging tests are computerized tomography (CT) and magnetic resonance imaging (MRI) scans. A CT scan uses a series of computer-directed X-rays to provide a comprehensive view of your brain. An MRI doesn't use X-rays. Instead, it combines magnetism, radio waves and computer technology to produce clear images of your brain.


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