The Red-Light District

Exploring the carnal and taboo

Cluster Headaches

Cluster headaches are the worst.

For all the problems that I do face, I’m exceedingly grateful for the ones that I don’t. For example, I'm blessed not to have cluster headaches. I remember hearing that the pain of cluster headaches has driven some men to suicide. A recent article in American Family Physician titled “Cluster Headache” reminds me how terrible this condition can be.

Cluster headaches cause severe pain around the eyes or on one side of the head. They last from about 15 minutes to (an excruciating) 3 hours and normally first affect men aged 20- to 40-years-old. The cluster period can last from weeks to months which means that a person diagnosed with these headaches will suffer a seemingly endless barrage of pain. In addition to the pain, people diagnosed with cluster headaches also experience allergy-like symptoms—runny nose, watery eyes and so forth. And in a particularly cruel twist of pathology, cluster headaches can begin during sleep.

Researchers are unsure why people develop cluster headaches. The possible causes are diverse and include dilation or widening of blood vessels, trigeminal nerve stimulation, histamine release or disruption of circadian rhythms. Sufferers are likely genetically predisposed to the condition and having a first-degree relative with a disease increases risk by 14- to 39-fold.

Treatment comes in various forms and can be preventive, acute or abortive. People with cluster headaches are encouraged to avoid possible triggers such as smoking and alcohol. Verapamil, a medication used to treat high blood pressure, may provide prophylactic or preventive relief. Acute treatment involves the use of supplemental oxygen and triptans, a class of medication also used to treat migraines. If all else fails, surgery is a last option.

On a final note, I would normally never refer to people with disease as “sufferers.” After all, suffering is a subjective experience that implies a more general assessment of a person’s life condition. For example, a person with paraplegia may not be “suffering” at all and live a happy and productive life. Nevertheless, I am convinced that a person with chronic cluster headaches is suffering. For the vast majority of people, cluster headaches are wicked.

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Naveed Saleh, M.D., M.S., attained a medical degree from Wayne State University School of Medicine and a master's degree in science journalism from Texas A&M.

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