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Cluster headache
What's new
Updated 2024 VA/DoD guidelines for the management of cluster headache .
Background
Overview
Definition
CH is a primary headache disorder characterized by severe unilateral pain mainly in the first division of the trigeminal nerve accompanied by ipsilateral cranial autonomic symptoms and a sense of agitation and restlessness during attacks.
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Pathophysiology
CH is caused by the activation of trigeminovascular complex and trigeminal-autonomic reflex.
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Disease course
Clinical manifestations include excruciating, unilateral headache over the peri- and retro-orbital regions and the temple accompanied by ipsilateral lacrimation, eye redness, eye discomfort, ptosis, nasal congestion, rhinorrhea, aural fullness, throat swelling, flushing, sense of restlessness, and agitation. Episodic headaches may subsequently become chronic headaches or may remit with age.
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Prognosis and risk of recurrence
CH is not associated with increased mortality.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of cluster headache are prepared by our editorial team based on guidelines from the American Society of Interventional Pain Physicians (ASIPP/NASS/AAPM/ASRA/IPSIS 2024), the United States Department of Defense (DoD/VA 2024), the European Academy of Neurology (EAN 2023), the American Headache Society (AHS 2016), and the American Academy of Family Physicians (AAFP ...
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