"The pathophysiology of CH is not well known. The most widely accepted theory is that primary CH is characterized by hypothalamic activation with secondary activation of the trigeminal-autonomic reflex, probably by a trigeminal-hypothalamic pathway (Nesbitt & Goadsby 2012). Cluster headache has also been associated with heart disease. "
[Show abstract][Hide abstract] ABSTRACT: Cluster headache is a primary headache by definition not caused by any known underlying structural pathology. Symptomatic cases have been described, for example tumours, dissections and infections, but a causal relationship between the underlying lesion and the headache is difficult to determine in many cases. The proper diagnostic evaluation of cluster headache is an issue unresolved. The literature has been reviewed for symptomatic cluster headache or cluster headache-like cases in which causality was likely. The review also attempted to identify clinical predictors of underlying lesions in order to formulate guidelines for neuroimaging. Sixty-three cluster headache or "cluster headache-like"/"cluster-like headache" cases in the literature were identified which were associated with an underlying lesion. A majority of the cases had a non-typical presentation that is atypical symptomatology and abnormal examination (including Horner's syndrome). A striking finding in this appraisal was that a significant proportion of CH cases were secondary to diseases of the pituitary gland or pituitary region. Another notable finding was that a proportion of cluster headache cases were associated with arterial dissection. Even typical cluster headaches can be caused by structural lesions and the response to typical cluster headache treatments does not exclude a secondary form. It is difficult to draw definitive conclusions from this retrospective review of case reports especially considering the size of the material. However, based on this review, I suggest that neuroimaging, preferably contrast-enhanced magnetic resonance imaging/magnetic resonance angiography should be undertaken in patients with atypical symptomatology, late onset, abnormal examination (including Horner's syndrome), or those resistant to the appropriate medical treatment. The decision to perform magnetic resonance imaging in cases of typical cluster headache remains a matter of medical art.
"The majority wrote that they had not observed any abnormal psychological disorders in their patients (Nieman and Hurwitz 1961; Schiller 1960; Symonds 1956). Skepticism about the existence of a cluster personality persisted until 1969, when John R. Graham, another of Wolff's students and soon-to-be president of the AHS (from 1976 to 1978), presented his research on the cluster personality at a symposium (Graham 1969)—research that he published in 1972. "
[Show abstract][Hide abstract] ABSTRACT: Cluster headache is a notoriously painful and dramatic disorder. Unlike other pain disorders, which tend to affect women, cluster headache is thought to predominantly affect men. Drawing on ethnography, interviews with headache researchers, and an analysis of the medical literature, this article describes how this epidemiological “fact”—which recent research suggests may be overstated—has become the central clue used by researchers who study cluster headache, fundamentally shaping how they identify and talk about the disorder. Cluster headache presents an extreme case of medicalized masculinity, magnifying the processes of gendering and bringing into relief features of the world whose routine operation we might otherwise overlook.
Gender & Society 10/2006; 20(5):632-656. DOI:10.1177/0891243206290720 · 2.41 Impact Factor
"Attacks are often accompanied by restlessness and signs of autonomic dysfunction such as lacrimation , nasal congestion, miosis, eyelid oedema, and conjunctival injection. The pathogenesis of the disease is still poorly understood . Observations of circadian biological changes and neuroendocrine disturbances have suggested a pivotal role of the hypothalamus in cluster headache . "
[Show abstract][Hide abstract] ABSTRACT: We report the case of a patient suffering from migraine without aura since childhood who, at the age of 58 years, developed cluster headache (CH) attacks. This second type of headache was related to an aneurysm of the anterior communicating artery (ACoA) whose bursting caused subarachnoid haemorrhage. The aneurysm's clipping made the cluster headache subside and there was no recurrence for almost four years. However, nine months after haemorrhage, the patient experienced new migraine without aura attacks. As a pathogenetic interpretation of this secondary cluster headache, we discuss the possible role of pericarotid sympathetic nerves in cluster headache attacks. We suggest that the surgical dissection of the pericarotid sympathetic fibres could prevent the onset of the cluster headache attacks by cutting part of the circuit underlying it.
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