August 2011 Condition of the Month- Headaches: Cluster Headaches and Sinus Headaches

 Cluster Headaches

Cluster headaches are typically very short in duration, excruciating headaches, usually felt on one side of the head behind the eyes.  Cluster headaches affect about 1 million people in the United states and, unlike migraines, are much more common in men between the ages of 20 and 40.

This is the only type of headache that tends to occur at night.  The reason that they are called 'cluster' headaches is that they tend to occur one to four times per day over a period of several days.  After one cluster of headaches is over, it may be months or even years, before they occur again.  They come on abruptly, with intense throbbing pain arising high in one nostril and spreading behind the eye on that side of the face.  Without apparent reason, the cluster may subside as quickly as it began.

• Affect only 1% of the population, with a ratio of 85% men to 15% women.
• Referred to as “suicide headaches” because of the intense pain. Women describe the pain as “worse than giving birth”.
• Usually will begin slowly and gradually.
• Can last from 30 minutes to several days. In chronic cases, may persist for many months.
• Immediate onset, with no “early warning” signs
• Frequent attacks during a “cluster period”, occur several times a day for weeks and months at a time. One to two cluster periods a year. Duration 15 minutes to three hours
• Excruciating pain affects one eye; may extend to forehead, cheek, head, and neck.
• Swelling, drooping, redness, sweating and/or tearing in or around affected eye.
• Stuffy or runny nose on same side as affected eye. Nausea/vomiting
• May shift between eyes during the same cluster period.
• Unlike Migraine sufferers, Cluster sufferers prefer to sit up, stand or pace.
• No one is sure of exact cause. Because of the cyclic regularity, may be tied into the body’s “biological clock” located deep in the brain in the hypothalamus.
• Other areas of interest include changes in levels of brain neurotransmitters, s.a. serotonin and changes in levels of certain hormones s.a. cortisol and melatonin.
• Drinking alcohol during a cluster period often triggers a headache.

Sinus Headaches

Sinus headaches cause a dull, deep, throbbing pain in the front of your head and face.  They are caused by an inflammation in your sinuses (air-filled cavities around your nose, eyes, and cheeks).  Bending down or leaning over generally makes the pain worse, as does cold and damp weather.  Sinus headaches often begin as soon as as you get up in the morning, and may be better by afternoon. Sinus headaches can be difficult to diagnose, however, because symptoms are similar to tension headaches and migraines.

• Pressure like pain in one specific area of face or head
• Face is tender to touch
• Sudden temperature changes, like going into cold from a warm room may worsen pain.
• Headache starts when you have a bad cold or just after.
• May be caused by anything that keep the sinuses from draining.
• Risk factors may include: history of allergies or asthma, nasal polyps, climbing or flying to high altitudes, frequent swimming and/or diving.
• Other symptoms related to sinus inflammation:
• Postnasal drip with a sore throat.
•  Yellow or green discharge from your nose.
• Red and swollen nasal passages.
• Mild to moderate fever.
• General sense of not feeling well.
• Fatigue