| One-Minute Clinician

Cluster Headaches

Cluster headache is more common in men than women. These patients have absolutely horrible pain to the point where it’s also called a suicide headache. The headache lasts 45 minutes to three hours, whereas migraine goes four hours to 72 typically. Even though it’s a vascular headache it starts from a different part of the brain, the hypothalamus not the trigeminal nucleus caudalis, which is the migraine generator, and these folk can’t lie down. They cannot be comfortable anywhere. They will literally hit their heads against the wall to try to create pain that will have them shift their awareness of the pain away from the terrible pain of the cluster headache, which is described by, I’d say, 9 out of every 10 cluster patients I’ve ever seen as, “There’s somebody inside my skull trying to push my eye out with a hot poker.” I say that, and what’s fascinating to me is people that, to my knowledge, have never met each other have the same explanation almost word-for-word.

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