Cluster headache How we diagnose and what can we improve? Dr Alina Buture Research Fellow in Neurology
Cluster headache How we diagnose and what can we improve?
Dr Alina Buture Research Fellow in Neurology
Cluster headache
• Uncommon condition
• Prevalence 1/1000
• The worst pain known to man
• Female patients who suffer from cluster
headache describe the pain
as ‘worse than childbirth’
http://pregnancyhumor.com
Excruciating headaches
How to recognise cluster headache?
http://khannea-suntzu.zerostate.net
How to recognise cluster headache?
Strictly unilateral/frontal/around eyeball
Cluster Headache by JD Fletcher
How to recognise cluster headache?
Runny nose/blood shot/droopy eye
http://www.ati-spg.com
How to recognise cluster headache?
Duration: 15-120 min
https://www.fotolia.com
How to recognise cluster headache?
Early morning attacks
https://www.pexels.com
How to recognise cluster headache?
https://thesaurus.plus
Restlessness
How to recognise cluster headache?
More common in men
https://vectortoons.com
How to recognise cluster headache?
More common in smokers
https://es.pngtree.com/freepng
How to recognise cluster headache?
Triggered by alcohol
http://blogaboutbeer.com
Episodic vs chronic cluster headache
Episodic
Chronic
Misdiagnosis and delays in diagnosis
Not everyone fits in the box
https://imgflip.com
Misdiagnosis and delays in diagnosis
No specific tests available
https://www.keepcalm-o-matic.co.uk
Misdiagnosis and delays in diagnosis
Misdiagnosis in ED and primary care
http://www.reframehealthfilms.com
Misdiagnosis and delays in diagnosis
Trigeminal neuralgia
http://www.cohenkayedental.com
Misdiagnosis and delays in diagnosis
Sinusitis
http://www.cohenkayedental.com
Neuropeptides in cluster headache
CGRP PACAP VIP NPY
Normal MRI head
Functional MRI in cluster headache
Morelli et al. J Headache Pain (2009) 10:11–14
How can we improve the diagnosis of cluster headache?
• Educational activities for doctors (GPs, ED, ENT doctors)
• Blood tests, brain scans – research
• Screening tools
Screening tool for cluster headache