Cluster Headache Vs Migraine:
Migraine and CH therapy includes the acute therapy to abort the single attack, and preventive therapy to reduce attack frequency, duration and severity and the use of acute headache medications. In migraine, delayed attacks are thought to arise from the pharmacological trigger playing a role relatively early in spontaneous migraine attack initiation [114]. reference Thus, the short time to attack in CH might reflect a shorter cascade of events in CH attack initiation relative to migraine. In addition to the above-mentioned studies involving brainstem and hypothalamus, patients with primary headaches experience dynamic structural [93] and functional [75] changes in cortical-subcortical areas involved in nociception.
If a person with a tension headache experiences severe stress or trauma, this may cause them to develop migraine features, such as a visual aura. Below are some frequently asked questions about migraine attacks and headaches. The glymphatic system helps remove toxins from the brain that build up during wakefulness.
It may also be caused by an aneurysm, stroke, or other injury. Often confused with migraine, sinus headaches co-occur with sinus infection symptoms like fever, stuffy nose, cough, congestion, and facial pressure. A 2018 survey found that sinus infections affect about 11.6% of adults. Each cluster period may start at about the same time of year and last about the same length of time.
A migraine lasts longer ‘ often the entire day or potentially several days if left untreated. While it’s uncommon to have more than one migraine a day, it’s possible to have up to eight cluster headaches in one day. With cluster headaches, there are pain-free periods between the headaches. Migraine headaches often fluctuate in severity over the course of one headache, but the pain doesn’t go away completely. The hypothalamus is involved in numerous physiological functions including controlling circadian rhythm [22, 69]. Furthermore, it has several connections involved in pain modulation in migraine as well as in cluster headache [36].
However, if a person has underlying migraine, it’s very common that upper respiratory infections (like a sinus infection) can flare one’s migraine attacks. In that case, the headache that came with the infection was not caused by the sinuses but was caused by the underlying migraine condition. One of the most confusing topics in headache medicine is the intersection of sinusitis, sinus headache, and sinus allergies. It is very common for someone to receive a diagnosis of sinusitis or allergies when they are actually experiencing migraine attacks. Tension-type headache is typically treated with over-the-counter pain medicines such as NSAIDs or acetaminophen (Tylenol). Nonmedication treatments such as relaxation, massage, physical therapy, acupuncture, or cognitive behavioral therapy can also be used.
In CH, cases of sildenafil (prescribed for erectile dysfunction) triggering CH attacks in active phase [129, 130] and even triggering an active phase itself [131] have been reported. In a randomized, double-blind, placebo controlled cross-over study in 12 MwoA patients, vasoactive signaling molecule CGRP was infused intravenously (2.0 ‘g/min for 20 min) [132]. In the paper, authors stated that three of nine MO patients developed delayed migraine attacks as strictly defined by criteria from the International Headache Society on CGRP compared to zero of nine on placebo. When revisiting these results and applying newer, modified criteria for pharmacologically induced migraine-like attacks, CGRP induced delayed migraine-like attacks in six of nine MO patients compared to one in nine after placebo [133]. CGRP induced cluster-like attacks in 89% of episodic active phase patients compared to 11% after placebo, and in 50% of chronic patients compared to 0% after placebo. In episodic remission phase CH patients neither CGRP nor placebo induced any attacks.
Cluster headaches can be more severe than a migraine, but they usually don’t last as long. Anti-inflammatory medications (NSAIDs like ibuprofen) aren’t effective medications to treat cluster headaches. In addition, research found that cluster headaches may happen if there’s dysfunction in the area of your brain called the hypothalamus. This happens to about 1 in 5 people who get cluster headaches. You may experience slight discomfort or a burning feeling on one side of your head just before a cluster headache.
Combining drugs and behavioral treatment seems to be more effective than betablockers alone or behavioral treatment alone [90]. In a four-armed randomized controlled trial, 232 migraine patients were randomized to placebo, betablockers, behavioral treatment and placebo or behavioral treatment and betablocker [90]. The combination of betablockers and behavioral treatments improved treatment outcomes and outcomes of acute treatment.
The intensity dependence of auditory evoked potentials is also increased in CH patients, during and outside active phase, possibly suggesting decreased serotoninergic activity in the hypothalamic pathways [92]. 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. (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. If you’re experiencing pain from a cluster headache or migraine, talk to your doctor to receive a proper diagnosis. These are the least common type of headaches, affecting fewer than one in 1,000 people.
Some people may experience migraine attacks so severe that they seek care at an emergency room. It usually occurs in periods of frequent attacks known as clusters. These headaches cause intense this content pain in or around one eye on one side of the head. Many people experience multiple cluster headaches for six to 12 weeks, followed by remission (period of no attacks), lasting months to years.
Migraine is often such a nebulous disorder that it can masquerade as other headache disorders, like hypnic headache, quite easily. Cluster headache is an uncommon headache disorder that falls under the umbrella of disorders called trigeminal autonomic cephalalgias (TACs). That’s a complicated term for one-sided headaches with autonomic features, which are basically things that this page your nervous system controls without your having to think about it. However, as we gather more evidence, a more-nuanced picture is beginning to develop. It seems that some things that we thought were triggers may be cravings induced by migraine activity. Instead of triggering migraine attacks, some of these things are likely craved and eaten due to a migraine-in-progress.
In CH, activation in the hypothalamic grey matter ipsilateral to the side of a headache during attacks is seen with PET [74] and fMRI [75]. Also, altered functional connectivity of the hypothalamus and anterior thalamus were described. A voxel-based morphometry (VBM) study [64] revealed concomitant grey matter volume increase of this hypothalamic region, but other VBM studies did not substantiate these results [76’79]. However, although we cannot exclude that some patients might inherit CH in a mendelian fashion, multifactorial inheritance, as is almost always also the case in migraine, seems likely [60, 61].
Migraine episodes will typically affect only one side of the head. However, it’s possible to have a migraine episode that affects both sides of the head. A migraine attack will cause intense pain that may be throbbing and will make performing daily tasks very difficult. Even bad headache pain isn’t usually the result of another disease. But headaches can sometimes mean a serious medical condition.