Materiały źródłowe

• #1 Cluster Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544241/

  Cluster headaches are the most common of the primary headache type known as trigeminal autonomic cephalgia. […] The exact etiology of cluster headaches is not clear. There have been several theories suggested and tested. […] Some studies have suggested a genetic component, and multiple loci associated with cluster headaches have been identified. […] There is a known association between the trigeminovascular system, the parasympathetic nerve fibers involved in the trigeminal autonomic reflex, and the hypothalamus. […] The hypothalamus has a definite association with cluster headaches. […] The parasympathetic nerve fibers are part of the trigeminal autonomic reflex.

• #2 Cluster headache: Epidemiology, clinical features, and diagnosis – UpToDate

  https://www.uptodate.com/contents/cluster-headache-epidemiology-clinical-features-and-diagnosis

  Cluster headache is the most common form of the trigeminal autonomic cephalalgias (TACs), a group of idiopathic headache disorders characterized by recurrent attacks of unilateral severe headache accompanied by ipsilateral cranial autonomic symptoms. […] The TACs include cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks, and hemicrania continua. Cluster headache is the most common form.

• #3 Cluster Headache: Epidemiology, Pathophysiology, Clinical Features, and Diagnosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5909131/

  Cluster headache is a primary headache disorder affecting up to 0.1% of the population. […] Experimental, clinical, and neuroimaging studies have advanced our understanding of the pathogenesis of cluster headache. The pathophysiology involves activation of the trigeminovascular complex and the trigeminal-autonomic reflex and accounts for the unilateral severe headache, the prominent ipsilateral cranial autonomic symptoms. […] The pathophysiology of cluster headache is complex and the underlying mechanisms are not fully elucidated. Cluster headache is a neurovascular rather than a vascular headache, with vascular cerebral changes being driven by the effects of trigeminal-autonomic reflex activation. […] The trigeminovascular pathway consists of neurons innervating the cerebral vessels and dura mater through cell bodies in the trigeminal ganglion.

• #4 Cluster headache – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cluster-headache/symptoms-causes/syc-20352080

  Experts don’t know what causes cluster headache. […] Cluster headache patterns suggest a link to the area of the brain that helps run the body’s biological clock, known as the hypothalamus. […] There are several cluster headache triggers. The most common is drinking alcohol. Other triggers might include weather changes and certain medicines.

• #5 Headaches – cluster Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/report/headaches-cluster

  Cluster headaches are among the most painful, and least common, of all headaches. The cause of cluster headaches is unknown. They are likely due to an interaction of abnormalities in the blood vessels, nerves, and chemicals that affect regions in the face. […] Evidence strongly suggests that abnormalities in the hypothalamus, a complex structure located deep in the brain, play a major role in cluster headaches. Advanced imaging techniques have shown that a specific area in the hypothalamus is activated during a cluster headache attack. […] Cluster headaches are associated with dilation (widening) of blood vessels and inflammation of nerves behind the eye. […] Cluster headaches may be caused by blood vessel dilation in the eye area. Inflammation of nearby nerves may give rise to the distinctive stabbing, throbbing pain usually felt in one eye. […] What causes these events and how they relate to cluster headaches are still unclear. Because blood vessel dilation appears to follow, not precede, the pain, some action originating in the brain is likely to be part of the process.

• #6 Why Are Cluster Headaches Affected by the Seasons?

  https://www.migrainedisorders.org/cluster-headaches-seasonal-impact/

  Cluster headaches are the most common form of the trigeminal autonomic cephalalgias. […] Why cluster headaches are linked to seasonal changes is likely due to the amount of daylight that occurs. […] The link between cluster headaches and seasons, time of day, and sleep cycles points researchers to the hypothalamus—a small area of the brain that regulates the body’s biological clock, hormones, and circadian rhythms. […] With cluster headaches, it’s believed that there is a periodic derangement of the hypothalamus that causes the attacks, but the how and why are still not understood. […] Although the cause of cluster headaches is still unknown, there are ongoing genetic studies.

• #7 Cluster Headache: History, Mechanisms, and Most Importantly, Treatment Options

  https://practicalneurology.com/diseases-diagnoses/headache-pain/cluster-headache-history-mechanisms-and-most-importantly-treatment-options/30363/

  The first is the hypothalamus, which may be the location where cluster attacks originate. Not only is the hypothalamus the site of the circadian pacemaker in the suprachiasmatic nucleus, but imaging data shows preferential activation of the posterior hypothalamus at the onset of a cluster headache. Anatomical and functional changes of the hypothalamus have also been seen in cluster headache patients, as have alterations in hypothalamic and pituitary molecules such as orexin, melatonin, and luteinizing hormone. […] The second system involved in cluster headache is the autonomic system, specifically the superior salivatory nucleus and the sphenopalatine ganglion, which includes molecules such as vasoactive intestinal peptide that have been shown to be altered in cluster headache. Stimulation of the sphenopalatine ganglion can trigger or abort a cluster headache attack, depending on the setting.

• #8 Cluster Headaches: Eye Pain Causes and Everyday Relief

  https://www.verywellhealth.com/cluster-headaches-7548851

  Cluster headaches cause significant pain on one side of the head, in the trigeminal nerve distribution (generally in or around the eye or temple). […] While the exact cause of cluster headaches is unknown, experts suspect they start with activating the hypothalamus, a gland at the base of the brain that controls your sleep-wake cycles and circadian rhythm (internal clock). […] Activation of the trigeminal-autonomic reflex (possibly via a connection with the hypothalamus) is suspected of generating cluster headaches. […] Lastly, genetics and hormone levels, namely melatonin (sleep hormone) and cortisol (stress hormone), may also play a role in causing cluster headaches. One study found lower melatonin and higher cortisol levels in participants with cluster headaches. […] Cluster headaches cause a sharp, piercing one-sided pain in or around the eye, eyebrow, or temple area. The cause is unknown but likely starts with activation of the hypothalamus (a gland in your brain).

• #9 Cluster headache – Wikipedia

  https://en.wikipedia.org/wiki/Cluster_headache

  The cause is unknown, but is most likely related to dysfunction of the posterior hypothalamus. […] Some experts consider the posterior hypothalamus to be important in the pathogenesis of cluster headaches. […] The specific causes and pathogenesis of cluster headaches are not fully understood. […] Therapies acting on the vagus nerve (cranial nerve X) and the greater occipital nerve have both shown efficacy in managing cluster headache, but the specific roles of these nerves are not well-understood. […] Cluster headache may run in some families in an autosomal dominant inheritance pattern. […] Possible genetic factors warrant further research, current evidence for genetic inheritance is limited. […] About 65% of persons with cluster headache are, or have been, tobacco smokers. […] A review suggests that the suprachiasmatic nucleus of the hypothalamus, which is the major biological clock in the human body, may be involved in cluster headaches, because cluster headaches occur with diurnal and seasonal rhythmicity.

• #10 Cluster Headache: Symptoms, Causes, and Treatment

  https://www.webmd.com/migraines-headaches/cluster-headaches

  Experts aren’t sure what causes cluster headaches. Theres evidence of a link to the hypothalamus, an area deep in your brain that controls things such as your body temperature, heart rate, and sleep cycles. […] Researchers do believe that the activation of a key „pathway” nerve is how the severe pain travels behind your eye, to your forehead, and jaw all on one side of your face.

• #11 Cluster Headache: Epidemiology, Pathophysiology, Clinical Features, and Diagnosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5909131/

  Cluster headache is a primary headache disorder affecting up to 0.1% of the population. […] Experimental, clinical, and neuroimaging studies have advanced our understanding of the pathogenesis of cluster headache. The pathophysiology involves activation of the trigeminovascular complex and the trigeminal-autonomic reflex and accounts for the unilateral severe headache, the prominent ipsilateral cranial autonomic symptoms. […] The pathophysiology of cluster headache is complex and the underlying mechanisms are not fully elucidated. Cluster headache is a neurovascular rather than a vascular headache, with vascular cerebral changes being driven by the effects of trigeminal-autonomic reflex activation. […] The trigeminovascular pathway consists of neurons innervating the cerebral vessels and dura mater through cell bodies in the trigeminal ganglion.

• #12 Cluster Headache: Epidemiology, Pathophysiology, Clinical Features, and Diagnosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5909131/

  The associated cranial autonomic symptoms characteristic of cluster headache arise from the reflex activation of the trigeminal-autonomic reflex pathway through parasympathetic outflow from the superior salivatory nucleus, the cranial facial nerve, through the sphenopalatine ganglion, resulting in vasodilatation and parasympathetic activation. […] These clinical features of cluster headache suggest a central mechanism, in particular, the hypothalamus. […] The role of the hypothalamus in cluster headache was further supported by the therapeutic effect of targeting the posterior hypothalamic gray through deep brain stimulation in cluster headache patients.

• #13 Cluster Headache: History, Mechanisms, and Most Importantly, Treatment Options

  https://practicalneurology.com/diseases-diagnoses/headache-pain/cluster-headache-history-mechanisms-and-most-importantly-treatment-options/30363/

  The first is the hypothalamus, which may be the location where cluster attacks originate. Not only is the hypothalamus the site of the circadian pacemaker in the suprachiasmatic nucleus, but imaging data shows preferential activation of the posterior hypothalamus at the onset of a cluster headache. Anatomical and functional changes of the hypothalamus have also been seen in cluster headache patients, as have alterations in hypothalamic and pituitary molecules such as orexin, melatonin, and luteinizing hormone. […] The second system involved in cluster headache is the autonomic system, specifically the superior salivatory nucleus and the sphenopalatine ganglion, which includes molecules such as vasoactive intestinal peptide that have been shown to be altered in cluster headache. Stimulation of the sphenopalatine ganglion can trigger or abort a cluster headache attack, depending on the setting.

• #14 Cluster Headache: History, Mechanisms, and Most Importantly, Treatment Options

  https://practicalneurology.com/diseases-diagnoses/headache-pain/cluster-headache-history-mechanisms-and-most-importantly-treatment-options/30363/

  The third system is the trigeminal nucleus, sometimes grouped with the large cranial blood vessels and meninges (the trigeminovascular system), or grouped with the upper cervical dorsal horns (the trigeminocervical complex). This area is likely involved in the pain component of cluster headache, and includes molecules such as calcitonin gene-related peptide, pituitary adenylate cyclase-activating peptide 38, and others that have been shown to be altered in cluster headache.

• #15 Cluster Headaches: Types, Symptoms, and Causes

  https://www.healthline.com/health/cluster-headache

  What Causes Cluster Headaches? The pain from cluster headaches is caused by the dilation, or widening, of the blood vessels that supply blood to your brain and face. This dilation applies pressure to the trigeminal nerve, which transmits sensations from the face to the brain. It is unknown why this dilation occurs. […] Researchers believe that abnormalities in the hypothalamus, a small area of the brain that regulates body temperature, blood pressure, sleep, and the release of hormones, may be responsible for cluster headaches. […] Cluster headaches may also be caused by a sudden release of the chemicals histamine, which fight allergens, or serotonin, which regulates mood.

• #16 Cluster Headache: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1142459-overview

  Cluster headache (CH), also known as histamine headache, is a primary neurovascular headache disorder, the pathophysiology and etiology of which are not well understood. […] The exact cause of cluster headache (CH) is unknown. The disorder is sporadic, though rare cases of an autosomal dominant pattern within a single family have been reported; CH may be autosomal dominant in about 5% of cases. […] Several factors have been shown to provoke CH attacks. Subcutaneous injection of histamine provokes attacks in 69% of patients. Stress, allergens, seasonal changes, or nitroglycerin may trigger attacks in some patients. Alcohol induces attacks during a cluster but not during remission. About 80% of CH patients are heavy smokers, and 50% have a history of heavy ethanol use. […] Risk factors for CH include the following: Male sex, Age older than 30 years, Small amounts of vasodilators (eg, alcohol), Previous head trauma or surgery (occasionally).

• #17 Cluster Headache | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0715/p122.html

  Cluster headache causes severe unilateral temporal or periorbital pain, lasting 15 to 180 minutes and accompanied by autonomic symptoms in the nose, eyes, and face. […] The pathophysiology of cluster headache is not fully understood, but may include a genetic component. […] The pathophysiology of cluster headache is not fully understood. Current theories implicate mechanisms such as vascular dilation, trigeminal nerve stimulation, and circadian effects. Histamine release, an increase in mast cells, genetic factors, and autonomic nervous system activation may also contribute. […] Acute cluster headache has been shown to involve activation of the posterior hypothalamic gray matter, and is inherited as an autosomal dominant condition in about 5% of patients. […] Having a first-degree relative with cluster headache increases the risk 14- to 39-fold. […] One study showed an association between cluster headache and the HCRTR2 gene. […] Disturbed circadian rhythms have been suggested as a possible contributor because headaches often begin during sleep.

• #18 Cluster Headache | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0715/p122.html

  Cluster headache causes severe unilateral temporal or periorbital pain, lasting 15 to 180 minutes and accompanied by autonomic symptoms in the nose, eyes, and face. […] The pathophysiology of cluster headache is not fully understood, but may include a genetic component. […] The pathophysiology of cluster headache is not fully understood. Current theories implicate mechanisms such as vascular dilation, trigeminal nerve stimulation, and circadian effects. Histamine release, an increase in mast cells, genetic factors, and autonomic nervous system activation may also contribute. […] Acute cluster headache has been shown to involve activation of the posterior hypothalamic gray matter, and is inherited as an autosomal dominant condition in about 5% of patients. […] Having a first-degree relative with cluster headache increases the risk 14- to 39-fold. […] One study showed an association between cluster headache and the HCRTR2 gene. […] Disturbed circadian rhythms have been suggested as a possible contributor because headaches often begin during sleep.

• #19 Cluster Headache: History, Mechanisms, and Most Importantly, Treatment Options

  https://practicalneurology.com/diseases-diagnoses/headache-pain/cluster-headache-history-mechanisms-and-most-importantly-treatment-options/30363/

  The cause of cluster headaches is poorly understood. About five to 10 percent of cluster headache patients have a family history of cluster headache, suggesting a genetic link. Presumably, cluster headache has multiple susceptibility genes. One of those genes may be the orexin/hypocretin receptor 2 (HCRTR2) which is implicated in sleep, narcolepsy, and hypothalamic functioning. Mutations in HCRTR2 were associated with cluster headache in two independent studies, but not in a third. Cluster headache patients are much more likely to use tobacco than the general population, and the rate of patent foramen ovale is higher, but a causative relationship with these factors has not been established. […] A small proportion of cluster headaches are secondary, giving some insight into different areas of the brain that may be involved. Cluster headaches have been associated with hypothalamic and pituitary tumors, meningiomas (anywhere from the cavernous sinus to the upper cervical spine), carotid artery dissections, vascular malformations, and sleep apnea. These associations, and the clinical features of cluster headache, suggest that there are three brain systems involved.

• #20 Frontiers | Cluster headache: an update on clinical features, epidemiology, pathophysiology, diagnosis, and treatment

  https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2024.1373528/full

  The neuroanatomical and functional systems involved in the pathophysiology of CH can be divided into three principal components: (1) the trigeminovascular system, (2) the trigeminal-autonomic reflex (sphenopalatine ganglion stimulation), and (3) the hypothalamic system. […] The interaction of these three components is responsible for the characteristic clinical presentation of CH. […] A GWAS study compared 852 CH cases from the UK and 591 from Sweden with 5,614 and 1,134 controls, respectively, identified a locus on chromosome 1 and confirmed a previous locus in the UK analysis on chromosome 6, which overlaps with a migraine locus. […] The major single nucleotide polymorphisms were rs113658130 and rs4519530 on chromosome 2, rs12121134 on chromosome 1, and rs11153082 on chromosome 6. These results have immunologic and pathogenic implications in CH.

• #21 Cluster Headache: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1142459-overview

  Cluster headache (CH), also known as histamine headache, is a primary neurovascular headache disorder, the pathophysiology and etiology of which are not well understood. […] The exact cause of cluster headache (CH) is unknown. The disorder is sporadic, though rare cases of an autosomal dominant pattern within a single family have been reported; CH may be autosomal dominant in about 5% of cases. […] Several factors have been shown to provoke CH attacks. Subcutaneous injection of histamine provokes attacks in 69% of patients. Stress, allergens, seasonal changes, or nitroglycerin may trigger attacks in some patients. Alcohol induces attacks during a cluster but not during remission. About 80% of CH patients are heavy smokers, and 50% have a history of heavy ethanol use. […] Risk factors for CH include the following: Male sex, Age older than 30 years, Small amounts of vasodilators (eg, alcohol), Previous head trauma or surgery (occasionally).

• #22 Cluster Headaches (CHs): Symptoms, Causes & Treatment | Ada

  https://ada.com/conditions/cluster-headaches/

  Cluster headaches are a subtype of headache called trigeminal autonomic cephalalgia (TAC). The exact causes of cluster headaches are unknown, but they are six times more likely to affect men than women. Currently identified possible triggers include stress, exposure to allergens and heavy alcohol use. […] CHs are linked to increased activity in a part of the brain called the hypothalamus, which contains a control center for many of the functions of the autonomic nervous system. A greater intensity in the activity of the hypothalamus during CH attacks has been detected by brain imaging studies on people affected by CHs. However, the exact relationship between CHs and the activity of the hypothalamus is not yet understood. […] They are also been linked to a person having elevated levels of histamine, a chemical produced as part of the body’s immune response to allergens. According to historical research into cluster headaches, people affected by CHs are likely to develop a headache attack when histamine is medically administered.

• #23 Cluster Headaches: Eye Pain Causes and Everyday Relief

  https://www.verywellhealth.com/cluster-headaches-7548851

  Cluster headaches cause significant pain on one side of the head, in the trigeminal nerve distribution (generally in or around the eye or temple). […] While the exact cause of cluster headaches is unknown, experts suspect they start with activating the hypothalamus, a gland at the base of the brain that controls your sleep-wake cycles and circadian rhythm (internal clock). […] Activation of the trigeminal-autonomic reflex (possibly via a connection with the hypothalamus) is suspected of generating cluster headaches. […] Lastly, genetics and hormone levels, namely melatonin (sleep hormone) and cortisol (stress hormone), may also play a role in causing cluster headaches. One study found lower melatonin and higher cortisol levels in participants with cluster headaches. […] Cluster headaches cause a sharp, piercing one-sided pain in or around the eye, eyebrow, or temple area. The cause is unknown but likely starts with activation of the hypothalamus (a gland in your brain).

• #24 Cluster Headache: History, Mechanisms, and Most Importantly, Treatment Options

  https://practicalneurology.com/diseases-diagnoses/headache-pain/cluster-headache-history-mechanisms-and-most-importantly-treatment-options/30363/

  The cause of cluster headaches is poorly understood. About five to 10 percent of cluster headache patients have a family history of cluster headache, suggesting a genetic link. Presumably, cluster headache has multiple susceptibility genes. One of those genes may be the orexin/hypocretin receptor 2 (HCRTR2) which is implicated in sleep, narcolepsy, and hypothalamic functioning. Mutations in HCRTR2 were associated with cluster headache in two independent studies, but not in a third. Cluster headache patients are much more likely to use tobacco than the general population, and the rate of patent foramen ovale is higher, but a causative relationship with these factors has not been established. […] A small proportion of cluster headaches are secondary, giving some insight into different areas of the brain that may be involved. Cluster headaches have been associated with hypothalamic and pituitary tumors, meningiomas (anywhere from the cavernous sinus to the upper cervical spine), carotid artery dissections, vascular malformations, and sleep apnea. These associations, and the clinical features of cluster headache, suggest that there are three brain systems involved.

• #25 Cluster Headache: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/5003-cluster-headaches

  Cluster headaches are a type of primary headache. […] Healthcare providers don’t know the exact cause of cluster headaches. Research found that they could relate to your body releasing the following near the trigeminal nerve that sends sensations between your face and brain: […] In addition, research found that cluster headaches may happen if there’s dysfunction in the area of your brain called the hypothalamus. […] Research also found that cluster headaches can be genetic in up to 5% of people. Studies are ongoing to learn more about the causes of cluster headaches. […] A trigger is something that causes your symptoms to start. Triggers during a cluster headache cycle vary from person to person but may include: […] Triggers can also affect the start of a new cycle of attacks after a period of no symptoms. […] You may be more at risk of cluster headaches if you:

• #26 Cluster Headache: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1142459-overview

  Cluster headache (CH), also known as histamine headache, is a primary neurovascular headache disorder, the pathophysiology and etiology of which are not well understood. […] The exact cause of cluster headache (CH) is unknown. The disorder is sporadic, though rare cases of an autosomal dominant pattern within a single family have been reported; CH may be autosomal dominant in about 5% of cases. […] Several factors have been shown to provoke CH attacks. Subcutaneous injection of histamine provokes attacks in 69% of patients. Stress, allergens, seasonal changes, or nitroglycerin may trigger attacks in some patients. Alcohol induces attacks during a cluster but not during remission. About 80% of CH patients are heavy smokers, and 50% have a history of heavy ethanol use. […] Risk factors for CH include the following: Male sex, Age older than 30 years, Small amounts of vasodilators (eg, alcohol), Previous head trauma or surgery (occasionally).

• #27 Cluster Headache: Symptoms and Treatment | Doctor

  https://patient.info/doctor/cluster-headaches-pro

  Recognised over 100 years ago, this condition is different from migraine – clinically, aetiologically and genetically. […] The underlying mechanism of headache is not fully understood and prophylactic treatments are therefore empirical. […] Cigarette smoking, a history of head injury, having an affected 1st degree relative and alcohol use are also associated risk factors for the development of cluster headache. […] A complete picture of the pathophysiological processes which cause a CH has been difficult to elucidate, particularly because the condition is rare and sample sizes are small. […] An association with the hypothalamus has been confirmed. […] Parasympathetic nerve fibres are involved, and cause the autonomic symptoms, including conjunctival injection or lacrimation, rhinorrhoea, and facial vasodilation.

• #28 The Cluster Headache: Just Like Clockwork

  https://www.nationwidechildrens.org/family-resources-education/family-resources-library/the-cluster-headache-just-like-clockwork

  Researchers now believe that cluster headaches, as well as migraines, are set off by a malfunction of neurotransmitters, in particular, serotonin. They control the action of the blood vessels in the head and neck. […] During a series, even small amounts of alcohol can bring on an attack. Smoking can increase the severity of cluster headaches during a cluster period. During these series, the blood vessels seem to change. They may become more susceptible to the action of these substances. The blood vessels are not as sensitive to these substances during headache-free periods. […] For some people, cluster headaches never disappear. These are known as chronic cluster headaches. People who have this form of cluster headaches don’t respond to usual forms of cluster therapy.

• #29 Cluster Headache: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1142459-overview

  Cluster headache (CH), also known as histamine headache, is a primary neurovascular headache disorder, the pathophysiology and etiology of which are not well understood. […] The exact cause of cluster headache (CH) is unknown. The disorder is sporadic, though rare cases of an autosomal dominant pattern within a single family have been reported; CH may be autosomal dominant in about 5% of cases. […] Several factors have been shown to provoke CH attacks. Subcutaneous injection of histamine provokes attacks in 69% of patients. Stress, allergens, seasonal changes, or nitroglycerin may trigger attacks in some patients. Alcohol induces attacks during a cluster but not during remission. About 80% of CH patients are heavy smokers, and 50% have a history of heavy ethanol use. […] Risk factors for CH include the following: Male sex, Age older than 30 years, Small amounts of vasodilators (eg, alcohol), Previous head trauma or surgery (occasionally).

• #30 The Cluster Headache: Just Like Clockwork

  https://www.nationwidechildrens.org/family-resources-education/family-resources-library/the-cluster-headache-just-like-clockwork

  Researchers now believe that cluster headaches, as well as migraines, are set off by a malfunction of neurotransmitters, in particular, serotonin. They control the action of the blood vessels in the head and neck. […] During a series, even small amounts of alcohol can bring on an attack. Smoking can increase the severity of cluster headaches during a cluster period. During these series, the blood vessels seem to change. They may become more susceptible to the action of these substances. The blood vessels are not as sensitive to these substances during headache-free periods. […] For some people, cluster headaches never disappear. These are known as chronic cluster headaches. People who have this form of cluster headaches don’t respond to usual forms of cluster therapy.

• #31 Cluster Headaches: Symptoms, Specialists, and Treatment Options

  https://headacheaustralia.org.au/headachetypes/cluster-headache/

  Cluster headache is a relatively rare but extremely painful type of headache, usually strictly one-sided, attacks in cyclical pattern and bouts. […] The cause of cluster headache is thought to be a disorder of an internal clock in the hypothalamus. […] While there is no good evidence to support a causal relationship between smoking and cluster headache, smokers are found to have more severe attacks in episodic cluster headache but not in chronic cluster headache.

• #32 Cluster Headache | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0715/p122.html

  Cluster headache causes severe unilateral temporal or periorbital pain, lasting 15 to 180 minutes and accompanied by autonomic symptoms in the nose, eyes, and face. […] The pathophysiology of cluster headache is not fully understood, but may include a genetic component. […] The pathophysiology of cluster headache is not fully understood. Current theories implicate mechanisms such as vascular dilation, trigeminal nerve stimulation, and circadian effects. Histamine release, an increase in mast cells, genetic factors, and autonomic nervous system activation may also contribute. […] Acute cluster headache has been shown to involve activation of the posterior hypothalamic gray matter, and is inherited as an autosomal dominant condition in about 5% of patients. […] Having a first-degree relative with cluster headache increases the risk 14- to 39-fold. […] One study showed an association between cluster headache and the HCRTR2 gene. […] Disturbed circadian rhythms have been suggested as a possible contributor because headaches often begin during sleep.

• #33 What Causes Cluster Headache Symptoms

  https://www.gammacore.com/what-causes-cluster-headache-symptoms/

  The exact cause of cluster headache is still being researched, but experts believe they are linked to abnormal activity in the hypothalamus, the part of the brain that controls the body’s biological clock. This could explain why attacks often occur at predictable times each day or during specific seasons. […] While the root cause is unclear, researchers have identified several triggers and contributing factors that may increase the likelihood of a cluster headache attack: Alcohol consumption: Even small amounts can trigger an attack during an active cluster period. Smoking and tobacco exposure: Tobacco use is linked to a higher risk of cluster headache. Disrupted sleep patterns: Changes in sleep schedules, including jet lag and shift work, may contribute to attacks. Extreme temperature or weather changes: Sudden shifts in barometric pressure or heat exposure can trigger symptoms. Certain medications: Vasodilators (like nitroglycerin) can provoke cluster headache in some individuals. […] Identifying your personal triggers can be key to reducing the frequency and intensity of cluster headaches.

• #34 Cluster headache in children | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/cluster-headache-children/

  Cluster headache is a type of headache that involves repeated attacks of very severe pain on one side of the head. […] We do not fully understand the exact cause of cluster headache. Cluster headache affects the parasympathetic nervous system, which causes the symptoms of autonomic dysfunction. It also seems to involve a part of the brain known as the hypothalamus, which helps to control our bodily rhythms. This may help to explain the regularity of attacks. […] Certain triggers are known to worsen cluster headaches. These include alcohol, certain fumes or strong smells, and being in a warm environment. Afternoon naps can also be a trigger for some people with cluster headaches. Cluster headaches are also more common in people who smoke.

• #35 Cluster headache – causes, symptoms and treatment | healthdirect

  https://www.healthdirect.gov.au/cluster-headache

  Cluster headaches are a rare but very painful type of headache, that occur very frequently, and for several weeks at a time. […] Doctors don’t know what causes cluster headaches. People who smoke have a greater risk of chronic cluster headaches. […] Cluster headaches sometimes run in families. […] Headaches may be triggered by: alcohol, foods that contain nitrates for example, meat, garlic or dark chocolate, strong smells, some medicines, such as nitroglycerin (which is used to treat chest pain).

• #36 Cluster headache – causes, symptoms and treatment | healthdirect

  https://www.healthdirect.gov.au/cluster-headache

  Cluster headaches are a rare but very painful type of headache, that occur very frequently, and for several weeks at a time. […] Doctors don’t know what causes cluster headaches. People who smoke have a greater risk of chronic cluster headaches. […] Cluster headaches sometimes run in families. […] Headaches may be triggered by: alcohol, foods that contain nitrates for example, meat, garlic or dark chocolate, strong smells, some medicines, such as nitroglycerin (which is used to treat chest pain).

• #37 What Is Cluster Headache? Symptoms, Causes, Diagnosis, and Treatment

  https://www.everydayhealth.com/headache/cluster-headache/guide/

  Cluster headaches involve a brain structure called the hypothalamus, as well as a branch of the trigeminal nerve a nerve that provides sensation to your face per the Cleveland Clinic. […] The causes of cluster headaches are still unclear. A cluster period may be triggered by an environmental factor like a change in seasons, and alcohol consumption during a cluster period can trigger a headache, Mayo Clinic notes. […] A cluster period often begins at or around the same time each year in a given person. That may be because of how the hypothalamus responds to changes in the timing of sunlight, as part of whats known as your circadian clock. […] During a cluster period, your headaches may or may not be connected to a known trigger. Headaches may be triggered by activities that cause the release of chemicals known as histamine or serotonin in your body, according to Johns Hopkins Medicine. These can include: Alcohol use, Tobacco use, Cocaine use, Physical activity, Changing to a higher altitude, Bright light, including sunlight, Hot weather, Hot bath or shower, Foods containing nitrites, such as bacon, sausage, or lunch meats, Certain medications, including nitroglycerin.

• #38 Cluster Headaches (CHs): Symptoms, Causes & Treatment | Ada

  https://ada.com/conditions/cluster-headaches/

  A person’s food intake may contain histamine-rich foods, which can cause CHs. Histamine levels in foods vary, depending on how processed, ripe or matured they are. Foods that are rich in histamine and may cause CHs include salty foods such as crisps and cured meats, alcohol, vinegar, cocoa and chocolate, shellfish, beans and pulses, and matured cheeses. […] Furthermore, having elevated levels of serotonin, a neurotransmitter has also been linked to CHs. Serotonin is mainly produced in the brain and is found in the nervous system and gut. It promotes feelings of well-being. […] However, the relationships between having elevated levels of histamine and/or serotonin and the development of CHs are also unknown.

• #39 Cluster Headache: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1142459-overview

  Cluster headache (CH), also known as histamine headache, is a primary neurovascular headache disorder, the pathophysiology and etiology of which are not well understood. […] The exact cause of cluster headache (CH) is unknown. The disorder is sporadic, though rare cases of an autosomal dominant pattern within a single family have been reported; CH may be autosomal dominant in about 5% of cases. […] Several factors have been shown to provoke CH attacks. Subcutaneous injection of histamine provokes attacks in 69% of patients. Stress, allergens, seasonal changes, or nitroglycerin may trigger attacks in some patients. Alcohol induces attacks during a cluster but not during remission. About 80% of CH patients are heavy smokers, and 50% have a history of heavy ethanol use. […] Risk factors for CH include the following: Male sex, Age older than 30 years, Small amounts of vasodilators (eg, alcohol), Previous head trauma or surgery (occasionally).

• #40 Cluster headache – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cluster-headache/symptoms-causes/syc-20352080

  Experts don’t know what causes cluster headache. […] Cluster headache patterns suggest a link to the area of the brain that helps run the body’s biological clock, known as the hypothalamus. […] There are several cluster headache triggers. The most common is drinking alcohol. Other triggers might include weather changes and certain medicines.

• #41 What Causes Cluster Headache Symptoms

  https://www.gammacore.com/what-causes-cluster-headache-symptoms/

  The exact cause of cluster headache is still being researched, but experts believe they are linked to abnormal activity in the hypothalamus, the part of the brain that controls the body’s biological clock. This could explain why attacks often occur at predictable times each day or during specific seasons. […] While the root cause is unclear, researchers have identified several triggers and contributing factors that may increase the likelihood of a cluster headache attack: Alcohol consumption: Even small amounts can trigger an attack during an active cluster period. Smoking and tobacco exposure: Tobacco use is linked to a higher risk of cluster headache. Disrupted sleep patterns: Changes in sleep schedules, including jet lag and shift work, may contribute to attacks. Extreme temperature or weather changes: Sudden shifts in barometric pressure or heat exposure can trigger symptoms. Certain medications: Vasodilators (like nitroglycerin) can provoke cluster headache in some individuals. […] Identifying your personal triggers can be key to reducing the frequency and intensity of cluster headaches.

• #42 What are the causes of cluster headaches in 2022?

  https://www.drhimanshugupta.com/blogs/what-are-the-causes-of-cluster-headaches

  Causes of cluster headaches: Cluster headaches are a type of headache that are due to a group of related headaches. […] But there are some causes of cluster headaches that individuals must be aware of. […] Cigarette smoke can be a cause of cluster headache. […] Alcohol can cause different types of headaches, but the most common type is called cluster headaches. […] When these headaches are due to by smells like perfume, cologne, or leather, it is known as scents cluster headache. […] Cluster headaches can take place due to the combination of factors such as stress, overuse, and anxiety. […] There is growing evidence that high altitude changes can be a cause of cluster headache. […] Cluster headache is a form of headaches that is due to by a specific type of light, usually white or yellow, being shone into the eye.

• #43 Cluster Headache: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1142459-overview

  Cluster headache (CH), also known as histamine headache, is a primary neurovascular headache disorder, the pathophysiology and etiology of which are not well understood. […] The exact cause of cluster headache (CH) is unknown. The disorder is sporadic, though rare cases of an autosomal dominant pattern within a single family have been reported; CH may be autosomal dominant in about 5% of cases. […] Several factors have been shown to provoke CH attacks. Subcutaneous injection of histamine provokes attacks in 69% of patients. Stress, allergens, seasonal changes, or nitroglycerin may trigger attacks in some patients. Alcohol induces attacks during a cluster but not during remission. About 80% of CH patients are heavy smokers, and 50% have a history of heavy ethanol use. […] Risk factors for CH include the following: Male sex, Age older than 30 years, Small amounts of vasodilators (eg, alcohol), Previous head trauma or surgery (occasionally).

• #44 Cluster headaches

  https://www.nhs.uk/conditions/cluster-headaches/

  Its not known what causes cluster headaches. […] Theyre more common in men in their 30s and 40s, or if you have a close family member who gets them. […] Some people find certain triggers can cause cluster headaches, such as: smoking, drinking alcohol, perfume, the smell of paint, nail varnish or petrol, exercise.

• #45 What Is Cluster Headache? Symptoms, Causes, Diagnosis, and Treatment

  https://www.everydayhealth.com/headache/cluster-headache/guide/

  Cluster headaches involve a brain structure called the hypothalamus, as well as a branch of the trigeminal nerve a nerve that provides sensation to your face per the Cleveland Clinic. […] The causes of cluster headaches are still unclear. A cluster period may be triggered by an environmental factor like a change in seasons, and alcohol consumption during a cluster period can trigger a headache, Mayo Clinic notes. […] A cluster period often begins at or around the same time each year in a given person. That may be because of how the hypothalamus responds to changes in the timing of sunlight, as part of whats known as your circadian clock. […] During a cluster period, your headaches may or may not be connected to a known trigger. Headaches may be triggered by activities that cause the release of chemicals known as histamine or serotonin in your body, according to Johns Hopkins Medicine. These can include: Alcohol use, Tobacco use, Cocaine use, Physical activity, Changing to a higher altitude, Bright light, including sunlight, Hot weather, Hot bath or shower, Foods containing nitrites, such as bacon, sausage, or lunch meats, Certain medications, including nitroglycerin.

• #46 Cluster headache Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/cluster-headache

  Doctors do not know exactly what causes cluster headaches. They seem to be related to the body’s sudden release of histamine (chemical in the body released during an allergic response) or serotonin (chemical made by nerve cells) in the area of a nerve in the face called the trigeminal nerve. A problem in a small area at the base of the brain called the hypothalamus may be involved. […] Cluster headaches may be triggered by: Alcohol, Cigarette smoking, High altitudes (trekking and air travel), Bright light (including sunlight), Exertion (physical activity), Heat (hot weather or hot baths), Foods high in nitrites (bacon and preserved meats), Certain medicines, Cocaine.

• #47 Cluster Headaches | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/cluster-headaches.html

  Cluster headaches are rare when compared with other types of headaches. Researchers don’t know exactly what causes cluster headaches. They seem to be related to the sudden release of histamine or serotonin in the body. […] The following may trigger cluster headaches: Alcohol use or smoking cigarettes, Change to a high altitude, Bright light, Exercise or exertion, Heat, from either the weather or a bath, Foods that contain nitrates, such as bacon or lunch meat, Cocaine use.

• #48 Cluster Headache: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/5003-cluster-headaches

  Cluster headaches are a type of primary headache. […] Healthcare providers don’t know the exact cause of cluster headaches. Research found that they could relate to your body releasing the following near the trigeminal nerve that sends sensations between your face and brain: […] In addition, research found that cluster headaches may happen if there’s dysfunction in the area of your brain called the hypothalamus. […] Research also found that cluster headaches can be genetic in up to 5% of people. Studies are ongoing to learn more about the causes of cluster headaches. […] A trigger is something that causes your symptoms to start. Triggers during a cluster headache cycle vary from person to person but may include: […] Triggers can also affect the start of a new cycle of attacks after a period of no symptoms. […] You may be more at risk of cluster headaches if you:

• #49 Cluster Headaches (CHs): Symptoms, Causes & Treatment | Ada

  https://ada.com/conditions/cluster-headaches/

  Cluster headaches are a subtype of headache called trigeminal autonomic cephalalgia (TAC). The exact causes of cluster headaches are unknown, but they are six times more likely to affect men than women. Currently identified possible triggers include stress, exposure to allergens and heavy alcohol use. […] CHs are linked to increased activity in a part of the brain called the hypothalamus, which contains a control center for many of the functions of the autonomic nervous system. A greater intensity in the activity of the hypothalamus during CH attacks has been detected by brain imaging studies on people affected by CHs. However, the exact relationship between CHs and the activity of the hypothalamus is not yet understood. […] They are also been linked to a person having elevated levels of histamine, a chemical produced as part of the body’s immune response to allergens. According to historical research into cluster headaches, people affected by CHs are likely to develop a headache attack when histamine is medically administered.

• #50 Cluster headaches

  https://www.nhs.uk/conditions/cluster-headaches/

  Its not known what causes cluster headaches. […] Theyre more common in men in their 30s and 40s, or if you have a close family member who gets them. […] Some people find certain triggers can cause cluster headaches, such as: smoking, drinking alcohol, perfume, the smell of paint, nail varnish or petrol, exercise.

• #51 What Is Cluster Headache? Symptoms, Causes, Diagnosis, and Treatment

  https://www.everydayhealth.com/headache/cluster-headache/guide/

  While cluster headaches can begin at any age, they usually develop between ages 20 and 40, according to the Cleveland Clinic. You may be at higher risk for cluster headaches if you have a parent or sibling who has them, but its also common to have no known family history of the condition. […] It has long been widely believed that men are at greater risk for cluster headaches than women. But many researchers now believe that cluster headaches affect women and men at roughly the same rate, according to the Cleveland Clinic.

• #52 What Is Cluster Headache? Symptoms, Causes, Diagnosis, and Treatment

  https://www.everydayhealth.com/headache/cluster-headache/guide/

  While cluster headaches can begin at any age, they usually develop between ages 20 and 40, according to the Cleveland Clinic. You may be at higher risk for cluster headaches if you have a parent or sibling who has them, but its also common to have no known family history of the condition. […] It has long been widely believed that men are at greater risk for cluster headaches than women. But many researchers now believe that cluster headaches affect women and men at roughly the same rate, according to the Cleveland Clinic.

• #53 Cluster Headache: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1142459-overview

  Cluster headache (CH), also known as histamine headache, is a primary neurovascular headache disorder, the pathophysiology and etiology of which are not well understood. […] The exact cause of cluster headache (CH) is unknown. The disorder is sporadic, though rare cases of an autosomal dominant pattern within a single family have been reported; CH may be autosomal dominant in about 5% of cases. […] Several factors have been shown to provoke CH attacks. Subcutaneous injection of histamine provokes attacks in 69% of patients. Stress, allergens, seasonal changes, or nitroglycerin may trigger attacks in some patients. Alcohol induces attacks during a cluster but not during remission. About 80% of CH patients are heavy smokers, and 50% have a history of heavy ethanol use. […] Risk factors for CH include the following: Male sex, Age older than 30 years, Small amounts of vasodilators (eg, alcohol), Previous head trauma or surgery (occasionally).

• #54 Frontiers | Cluster headache: an update on clinical features, epidemiology, pathophysiology, diagnosis, and treatment

  https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2024.1373528/full

  Cluster headache (CH) is one of the worst primary headaches that remain underdiagnosed and inappropriately treated. […] CH affects 0.1% of the population with an incidence of 2.07–9.8/100,00 person-years-habitants, a mean prevalence of 53/100,000 inhabitants (3–150/100,000 inhabitants). […] It is a polygenetic and multifactorial entity that involves dysfunction of the trigeminovascular system, the trigeminal autonomic reflex, and the hypothalamic networks. […] CH is considered a polygenic and genetic-environmental multifactorial disorder. […] Individuals with first-degree relatives with CH are 5–18 times more likely to experience CH than the general population, and if the relative is a second-degree family member, the risk is 1–3 times higher. […] The pathophysiology of CH still needs to be understood.

• #55 Frontiers | Cluster headache: an update on clinical features, epidemiology, pathophysiology, diagnosis, and treatment

  https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2024.1373528/full

  Cluster headache (CH) is one of the worst primary headaches that remain underdiagnosed and inappropriately treated. […] CH affects 0.1% of the population with an incidence of 2.07–9.8/100,00 person-years-habitants, a mean prevalence of 53/100,000 inhabitants (3–150/100,000 inhabitants). […] It is a polygenetic and multifactorial entity that involves dysfunction of the trigeminovascular system, the trigeminal autonomic reflex, and the hypothalamic networks. […] CH is considered a polygenic and genetic-environmental multifactorial disorder. […] Individuals with first-degree relatives with CH are 5–18 times more likely to experience CH than the general population, and if the relative is a second-degree family member, the risk is 1–3 times higher. […] The pathophysiology of CH still needs to be understood.

• #56 Cluster Headache: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1142459-overview

  Cluster headache (CH), also known as histamine headache, is a primary neurovascular headache disorder, the pathophysiology and etiology of which are not well understood. […] The exact cause of cluster headache (CH) is unknown. The disorder is sporadic, though rare cases of an autosomal dominant pattern within a single family have been reported; CH may be autosomal dominant in about 5% of cases. […] Several factors have been shown to provoke CH attacks. Subcutaneous injection of histamine provokes attacks in 69% of patients. Stress, allergens, seasonal changes, or nitroglycerin may trigger attacks in some patients. Alcohol induces attacks during a cluster but not during remission. About 80% of CH patients are heavy smokers, and 50% have a history of heavy ethanol use. […] Risk factors for CH include the following: Male sex, Age older than 30 years, Small amounts of vasodilators (eg, alcohol), Previous head trauma or surgery (occasionally).

• #57 Cluster Headache Causes, Symptoms, and Treatments | UPMC

  https://www.upmc.com/services/neurology/services/headache-center/cluster-headache

  Cluster headaches cause burning, piercing pain around your eye or temple on one side of your head. […] Doctors don’t know what causes cluster headaches. […] Since they happen more at night, the body’s sleep-wake cycle may play a role in triggering cluster headaches. […] People with a past head injury are more likely to have cluster headaches. […] And, some families are more at risk of cluster headaches. There may be a gene that passes from parent to child. […] Even though cluster headaches are more common in the fall, doctors don’t think seasonal allergies cause them. Food, hormones, or stress also aren’t usual triggers.

• #58 Cluster headache – Wikipedia

  https://en.wikipedia.org/wiki/Cluster_headache

  The cause is unknown, but is most likely related to dysfunction of the posterior hypothalamus. […] Some experts consider the posterior hypothalamus to be important in the pathogenesis of cluster headaches. […] The specific causes and pathogenesis of cluster headaches are not fully understood. […] Therapies acting on the vagus nerve (cranial nerve X) and the greater occipital nerve have both shown efficacy in managing cluster headache, but the specific roles of these nerves are not well-understood. […] Cluster headache may run in some families in an autosomal dominant inheritance pattern. […] Possible genetic factors warrant further research, current evidence for genetic inheritance is limited. […] About 65% of persons with cluster headache are, or have been, tobacco smokers. […] A review suggests that the suprachiasmatic nucleus of the hypothalamus, which is the major biological clock in the human body, may be involved in cluster headaches, because cluster headaches occur with diurnal and seasonal rhythmicity.

• #59 Cluster headache | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/cluster-headache?lang=us

  Cluster headaches are a particularly painful form of recurrent primary headache disorder, considered the most common trigeminal autonomic cephalalgia 1. […] Initially, however, many other causes of a severe headache may be thought of as possible etiologies, including: […] other trigeminal autonomic cephalalgias […] migraine […] reversible cerebral vasoconstriction syndrome […] subarachnoid hemorrhage […] structural lesions (e.g. tumors or hemorrhages).

• #60 Cluster headache: Epidemiology, clinical features, and diagnosis – UpToDate

  https://www.uptodate.com/contents/cluster-headache-epidemiology-clinical-features-and-diagnosis

  Cluster headache is the most common form of the trigeminal autonomic cephalalgias (TACs), a group of idiopathic headache disorders characterized by recurrent attacks of unilateral severe headache accompanied by ipsilateral cranial autonomic symptoms. […] The TACs include cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks, and hemicrania continua. Cluster headache is the most common form.

• #61 Cluster Headache: History, Mechanisms, and Most Importantly, Treatment Options

  https://practicalneurology.com/diseases-diagnoses/headache-pain/cluster-headache-history-mechanisms-and-most-importantly-treatment-options/30363/

  The cause of cluster headaches is poorly understood. About five to 10 percent of cluster headache patients have a family history of cluster headache, suggesting a genetic link. Presumably, cluster headache has multiple susceptibility genes. One of those genes may be the orexin/hypocretin receptor 2 (HCRTR2) which is implicated in sleep, narcolepsy, and hypothalamic functioning. Mutations in HCRTR2 were associated with cluster headache in two independent studies, but not in a third. Cluster headache patients are much more likely to use tobacco than the general population, and the rate of patent foramen ovale is higher, but a causative relationship with these factors has not been established. […] A small proportion of cluster headaches are secondary, giving some insight into different areas of the brain that may be involved. Cluster headaches have been associated with hypothalamic and pituitary tumors, meningiomas (anywhere from the cavernous sinus to the upper cervical spine), carotid artery dissections, vascular malformations, and sleep apnea. These associations, and the clinical features of cluster headache, suggest that there are three brain systems involved.

• #62 Cluster Headache: History, Mechanisms, and Most Importantly, Treatment Options

  https://practicalneurology.com/diseases-diagnoses/headache-pain/cluster-headache-history-mechanisms-and-most-importantly-treatment-options/30363/

  The cause of cluster headaches is poorly understood. About five to 10 percent of cluster headache patients have a family history of cluster headache, suggesting a genetic link. Presumably, cluster headache has multiple susceptibility genes. One of those genes may be the orexin/hypocretin receptor 2 (HCRTR2) which is implicated in sleep, narcolepsy, and hypothalamic functioning. Mutations in HCRTR2 were associated with cluster headache in two independent studies, but not in a third. Cluster headache patients are much more likely to use tobacco than the general population, and the rate of patent foramen ovale is higher, but a causative relationship with these factors has not been established. […] A small proportion of cluster headaches are secondary, giving some insight into different areas of the brain that may be involved. Cluster headaches have been associated with hypothalamic and pituitary tumors, meningiomas (anywhere from the cavernous sinus to the upper cervical spine), carotid artery dissections, vascular malformations, and sleep apnea. These associations, and the clinical features of cluster headache, suggest that there are three brain systems involved.

• #63 Frontiers | Cluster headache: an update on clinical features, epidemiology, pathophysiology, diagnosis, and treatment

  https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2024.1373528/full

  The neuroanatomical and functional systems involved in the pathophysiology of CH can be divided into three principal components: (1) the trigeminovascular system, (2) the trigeminal-autonomic reflex (sphenopalatine ganglion stimulation), and (3) the hypothalamic system. […] The interaction of these three components is responsible for the characteristic clinical presentation of CH. […] A GWAS study compared 852 CH cases from the UK and 591 from Sweden with 5,614 and 1,134 controls, respectively, identified a locus on chromosome 1 and confirmed a previous locus in the UK analysis on chromosome 6, which overlaps with a migraine locus. […] The major single nucleotide polymorphisms were rs113658130 and rs4519530 on chromosome 2, rs12121134 on chromosome 1, and rs11153082 on chromosome 6. These results have immunologic and pathogenic implications in CH.

• #64 Cluster Headache: History, Mechanisms, and Most Importantly, Treatment Options

  https://practicalneurology.com/diseases-diagnoses/headache-pain/cluster-headache-history-mechanisms-and-most-importantly-treatment-options/30363/

  The first is the hypothalamus, which may be the location where cluster attacks originate. Not only is the hypothalamus the site of the circadian pacemaker in the suprachiasmatic nucleus, but imaging data shows preferential activation of the posterior hypothalamus at the onset of a cluster headache. Anatomical and functional changes of the hypothalamus have also been seen in cluster headache patients, as have alterations in hypothalamic and pituitary molecules such as orexin, melatonin, and luteinizing hormone. […] The second system involved in cluster headache is the autonomic system, specifically the superior salivatory nucleus and the sphenopalatine ganglion, which includes molecules such as vasoactive intestinal peptide that have been shown to be altered in cluster headache. Stimulation of the sphenopalatine ganglion can trigger or abort a cluster headache attack, depending on the setting.

• #65 Cluster Headache: History, Mechanisms, and Most Importantly, Treatment Options

  https://practicalneurology.com/diseases-diagnoses/headache-pain/cluster-headache-history-mechanisms-and-most-importantly-treatment-options/30363/

  The first is the hypothalamus, which may be the location where cluster attacks originate. Not only is the hypothalamus the site of the circadian pacemaker in the suprachiasmatic nucleus, but imaging data shows preferential activation of the posterior hypothalamus at the onset of a cluster headache. Anatomical and functional changes of the hypothalamus have also been seen in cluster headache patients, as have alterations in hypothalamic and pituitary molecules such as orexin, melatonin, and luteinizing hormone. […] The second system involved in cluster headache is the autonomic system, specifically the superior salivatory nucleus and the sphenopalatine ganglion, which includes molecules such as vasoactive intestinal peptide that have been shown to be altered in cluster headache. Stimulation of the sphenopalatine ganglion can trigger or abort a cluster headache attack, depending on the setting.

• #66 Cluster Headache: History, Mechanisms, and Most Importantly, Treatment Options

  https://practicalneurology.com/diseases-diagnoses/headache-pain/cluster-headache-history-mechanisms-and-most-importantly-treatment-options/30363/

  The third system is the trigeminal nucleus, sometimes grouped with the large cranial blood vessels and meninges (the trigeminovascular system), or grouped with the upper cervical dorsal horns (the trigeminocervical complex). This area is likely involved in the pain component of cluster headache, and includes molecules such as calcitonin gene-related peptide, pituitary adenylate cyclase-activating peptide 38, and others that have been shown to be altered in cluster headache.

• #67 Entstehung und Ursachen – Schmerzklinik Kiel

  https://schmerzklinik.de/en/service-for-patients/know-about-cluster-headaches/emergence-and-causes/

  Eines der wesentlichen Merkmale des Clusterkopfschmerzes ist die Lokalisation hinter und um ein Auge herum. […] Es liegt deshalb nahe anzunehmen, dass der Sinus cavernosus die anatomische Struktur ist, die für die Genese des Clusterkopfschmerzes besonders von Relevanz ist. […] Dies weist darauf hin, dass im Sinus cavernosus eine entzündliche Veränderung in der Clusterkopfschmerzattacke abläuft. […] Aus diesen Untersuchungen kann geschlossen werden, dass das venöse Stromgebiet und der Sinus cavernosus für die Entstehung der Schmerzen des Clusterkopfschmerzes von wichtiger Bedeutung sind. […] Die Entstehung des Clusterkopfschmerzes ist aufgrund der anatomischen Strukturen und der o.g. Befunde im Bereich des Sinus cavernosus zu lokalisieren. […] Auch zwischen den Clusterkopfschmerzattacken wurden Gefä dilatationen im Bereich der A. ophthalmica und der A. cerebri anterior berichtet.

• #68 Entstehung und Ursachen – Schmerzklinik Kiel

  https://schmerzklinik.de/en/service-for-patients/know-about-cluster-headaches/emergence-and-causes/

  Eines der wesentlichen Merkmale des Clusterkopfschmerzes ist die Lokalisation hinter und um ein Auge herum. […] Es liegt deshalb nahe anzunehmen, dass der Sinus cavernosus die anatomische Struktur ist, die für die Genese des Clusterkopfschmerzes besonders von Relevanz ist. […] Dies weist darauf hin, dass im Sinus cavernosus eine entzündliche Veränderung in der Clusterkopfschmerzattacke abläuft. […] Aus diesen Untersuchungen kann geschlossen werden, dass das venöse Stromgebiet und der Sinus cavernosus für die Entstehung der Schmerzen des Clusterkopfschmerzes von wichtiger Bedeutung sind. […] Die Entstehung des Clusterkopfschmerzes ist aufgrund der anatomischen Strukturen und der o.g. Befunde im Bereich des Sinus cavernosus zu lokalisieren. […] Auch zwischen den Clusterkopfschmerzattacken wurden Gefä dilatationen im Bereich der A. ophthalmica und der A. cerebri anterior berichtet.

• #69 Entstehung und Ursachen – Schmerzklinik Kiel

  https://schmerzklinik.de/en/service-for-patients/know-about-cluster-headaches/emergence-and-causes/

  Phlebographische Untersuchungen ergeben Hinweise auf eine Phlebitis im Bereich der V. ophthalmica superior und im Bereich des Sinus cavernosus während einer Clusterkopfschmerzperiode. […] Hypothetisch kann angenommen werden, dass eine häufig beschriebene Enge der Luftwege im Bereich der Nasen- und Nasennebenhöhlen bei Patienten mit Clusterkopfschmerz zu einer Passagebehinderung der Belüftung der Ethmoidalzellen führen könnte und eine entsprechende ipsilaterale Infektion begünstigt wird. […] Die Entstehung der Schmerzen aus dem Schlaf heraus, das aufrechte Sitzen der Patienten im Bett bzw. das Aufstehen und die motorische Unruhe der Patienten ist verständlich: Die venöse Drainage des Sinus cavernosus ist im Liegen aufgrund der hydrostatischen Bedingungen schlechter als im Sitzen oder im Stehen.

• #70 Entstehung und Ursachen – Schmerzklinik Kiel

  https://schmerzklinik.de/en/service-for-patients/know-about-cluster-headaches/emergence-and-causes/

  Es kann daher angenommen werden, dass während aktiver Clusterperioden eine entzündliche Grundreaktion vorliegt, die attackenweise exazerbiert. […] Eine aktive Clusterkopfschmerzperiode ist somit assoziiert mit einer regionalen Plasmaeiweißextravasation in venösen Blutleitern der Hirnbasis als Zeichen einer lokalen vaskulären Entzündung. […] Die hohe und zuverlässige Wirksamkeit entzündungshemmend wirkender Kortikosteroide zur Prophylaxe von Clusterkopfschmerzen wird ebenfalls verständlich.

• #71 Entstehung und Ursachen – Schmerzklinik Kiel

  https://schmerzklinik.de/en/service-for-patients/know-about-cluster-headaches/emergence-and-causes/

  Eines der wesentlichen Merkmale des Clusterkopfschmerzes ist die Lokalisation hinter und um ein Auge herum. […] Es liegt deshalb nahe anzunehmen, dass der Sinus cavernosus die anatomische Struktur ist, die für die Genese des Clusterkopfschmerzes besonders von Relevanz ist. […] Dies weist darauf hin, dass im Sinus cavernosus eine entzündliche Veränderung in der Clusterkopfschmerzattacke abläuft. […] Aus diesen Untersuchungen kann geschlossen werden, dass das venöse Stromgebiet und der Sinus cavernosus für die Entstehung der Schmerzen des Clusterkopfschmerzes von wichtiger Bedeutung sind. […] Die Entstehung des Clusterkopfschmerzes ist aufgrund der anatomischen Strukturen und der o.g. Befunde im Bereich des Sinus cavernosus zu lokalisieren. […] Auch zwischen den Clusterkopfschmerzattacken wurden Gefä dilatationen im Bereich der A. ophthalmica und der A. cerebri anterior berichtet.

• #72 Entstehung und Ursachen – Schmerzklinik Kiel

  https://schmerzklinik.de/en/service-for-patients/know-about-cluster-headaches/emergence-and-causes/

  Phlebographische Untersuchungen ergeben Hinweise auf eine Phlebitis im Bereich der V. ophthalmica superior und im Bereich des Sinus cavernosus während einer Clusterkopfschmerzperiode. […] Hypothetisch kann angenommen werden, dass eine häufig beschriebene Enge der Luftwege im Bereich der Nasen- und Nasennebenhöhlen bei Patienten mit Clusterkopfschmerz zu einer Passagebehinderung der Belüftung der Ethmoidalzellen führen könnte und eine entsprechende ipsilaterale Infektion begünstigt wird. […] Die Entstehung der Schmerzen aus dem Schlaf heraus, das aufrechte Sitzen der Patienten im Bett bzw. das Aufstehen und die motorische Unruhe der Patienten ist verständlich: Die venöse Drainage des Sinus cavernosus ist im Liegen aufgrund der hydrostatischen Bedingungen schlechter als im Sitzen oder im Stehen.

• #73 Entstehung und Ursachen – Schmerzklinik Kiel

  https://schmerzklinik.de/en/service-for-patients/know-about-cluster-headaches/emergence-and-causes/

  Phlebographische Untersuchungen ergeben Hinweise auf eine Phlebitis im Bereich der V. ophthalmica superior und im Bereich des Sinus cavernosus während einer Clusterkopfschmerzperiode. […] Hypothetisch kann angenommen werden, dass eine häufig beschriebene Enge der Luftwege im Bereich der Nasen- und Nasennebenhöhlen bei Patienten mit Clusterkopfschmerz zu einer Passagebehinderung der Belüftung der Ethmoidalzellen führen könnte und eine entsprechende ipsilaterale Infektion begünstigt wird. […] Die Entstehung der Schmerzen aus dem Schlaf heraus, das aufrechte Sitzen der Patienten im Bett bzw. das Aufstehen und die motorische Unruhe der Patienten ist verständlich: Die venöse Drainage des Sinus cavernosus ist im Liegen aufgrund der hydrostatischen Bedingungen schlechter als im Sitzen oder im Stehen.

• #74 Entstehung und Ursachen – Schmerzklinik Kiel

  https://schmerzklinik.de/en/service-for-patients/know-about-cluster-headaches/emergence-and-causes/

  Es kann daher angenommen werden, dass während aktiver Clusterperioden eine entzündliche Grundreaktion vorliegt, die attackenweise exazerbiert. […] Eine aktive Clusterkopfschmerzperiode ist somit assoziiert mit einer regionalen Plasmaeiweißextravasation in venösen Blutleitern der Hirnbasis als Zeichen einer lokalen vaskulären Entzündung. […] Die hohe und zuverlässige Wirksamkeit entzündungshemmend wirkender Kortikosteroide zur Prophylaxe von Clusterkopfschmerzen wird ebenfalls verständlich.

• #75 Frontiers | Cluster headache: an update on clinical features, epidemiology, pathophysiology, diagnosis, and treatment

  https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2024.1373528/full

  The neuroanatomical and functional systems involved in the pathophysiology of CH can be divided into three principal components: (1) the trigeminovascular system, (2) the trigeminal-autonomic reflex (sphenopalatine ganglion stimulation), and (3) the hypothalamic system. […] The interaction of these three components is responsible for the characteristic clinical presentation of CH. […] A GWAS study compared 852 CH cases from the UK and 591 from Sweden with 5,614 and 1,134 controls, respectively, identified a locus on chromosome 1 and confirmed a previous locus in the UK analysis on chromosome 6, which overlaps with a migraine locus. […] The major single nucleotide polymorphisms were rs113658130 and rs4519530 on chromosome 2, rs12121134 on chromosome 1, and rs11153082 on chromosome 6. These results have immunologic and pathogenic implications in CH.

• #76

  https://journals.lww.com/neur/fulltext/2021/69001/cluster_headache__what_s_new_.17.aspx

  Cluster headache is a highly disabling primary headache disorder which is widely described as the most painful condition a human can experience. […] The pathophysiology of cluster headache and other primary headache disorders has recently become better understood and is thought to involve the hypothalamus and trigeminovascular system. […] The pathophysiology of CH remains poorly understood. The key features which would be accounted for by a comprehensive pathophysiological model include the trigeminal distribution of the pain, the presence of cranial autonomic symptoms, the periodicity of attacks, and the response to treatments such as triptans and oxygen. Overall there is no universal consensus on the pathophysiology of CH. The current leading view suggests that during attacks the trigeminovascular system and trigeminal-autonomic reflex become activated via a trigeminal-hypothalamic pathway under fluctuating control from the hypothalamus and other central pain-processing regions.

• #77 The cause of cluster headaches

  https://bellaireneurology.com/headaches/cluster-causes.html

  Very little is known about the source of cluster headaches. The best data available suggests that cluster headaches are somehow regulated by the posterior hypothalamic gray matter. This region of the brain is responsible for our circadian rhythms and our biologic functions such as appetite and temperature regulation. It is felt that a defect in this region occurs in patients who get cluster headaches and this is why they occur principally at night. The mechanism that triggers a series of cluster headaches and then eventually stops a series of cluster headaches is unknown.

• #78 What Causes A Cluster Headache? | My Headache Doc | Houston Texas

  https://myheadachedoc.com/headache-and-head-pain/cluster-headache/what-causes-a-cluster-headache/

  Unfortunately, very little is known about the source of cluster headaches. […] The best data available suggests that cluster headaches are somehow regulated by the posterior hypothalamic gray matter. This region of the brain is responsible for our circadian rhythms and our biologic functions such as appetite and temperature regulation. It is felt that a defect in this region occurs in patients who get cluster headaches and this is why they occur principally at night. The mechanism that triggers a series of cluster headaches and then eventually stops a series of cluster headaches is unknown.

• #79 5 Things To Know About Cluster Headache > News > Yale Medicine

  https://www.yalemedicine.org/news/cluster-headaches

  The cause of cluster headache is unknown, but the hypothalamus, a small area deep in the brain that modulates several neurobiological systems, has been shown to be activated during cluster attacks. […] Cluster headache is more common in men than in women, tends to run in families, and can happen at any age (though it most often arises in people in their 20s through middle age). […] Unfortunately, many people aren’t properly diagnosed with cluster headache, and even when they are, the treatment options are limited and don’t work for everyone, Dr. Schindler adds, which is why she is motivated to continue her research for better therapies.

• #80 Cluster Headache: Symptoms, Pain Relief Option, and Exploratory Treatments — Migraine Again

  https://www.migraineagain.com/cluster-headache/

  Headache specialists don’t have a clear understanding of what causes cluster headache. One thing that has been consistently observed in cluster headache is the activation of the part of the brain called the hypothalamus, which is responsible for a wide variety of functions like the reproductive cycle, the sleep/wake cycle, appetite, fluid balance, and other important homeostatic functions. The fact that cluster attacks occur with such a circadian pattern suggests that it has something to do with the „clock” in the hypothalamus that controls the sleep/wake cycle. […] Headache specialists also know that the hallmark of cluster headache is the activation of the autonomic nervous system. It is unknown what switches that on, but that sort of activation is also clearly a critical part of what’s happening with cluster headache. Apart from that, it remains in some ways mysterious, just like migraine, and probably even more so.

Zobacz więcej