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Cluster Headache FAQs (cont.)

Who gets cluster headaches?

Cluster headaches affect less than 1% of the population. Many more men than women suffer from them. (The male-to-female ratio may be as much as 5-8:1.) Most people have their first cluster headache during their mid twenties, although some have the first attacks in their teens or early fifties. Most people seem to have their most frequent attacks during middle age.

People who get cluster headaches often have a distinctive face. Typically, they are tall and rugged looking and have the following features:

  • Leonine (lionlike) facial appearance
  • Thickened skin with lots of very noticeable wrinkles
  • Broad chin
  • Vertical forehead creases
  • Nasal telangiectases (lesions formed by widened capillaries or small arteries)
    • These are largely the result of long-term heavy smoking.
    • Smoking worsens cluster headache symptoms.

Should a person with cluster headaches see a doctor?

Yes. Because of the severity of cluster headaches, the vast majority of people who have them seek medical care very soon. Those who do not must understand that a full evaluation by a doctor is needed to rule out the rare cases of cluster headache -like symptoms that might indicate meningitis (inflammation of the membranes of the brain or spinal cord), subarachnoid hemorrhage (bleeding in the brain), or brain tumor.

A doctor should be called if a person has any of the following problems:

  • A change in frequency, severity, or features of the headaches typically experienced
  • A progressively worsening headache that lasts for days
  • A headache brought on by what doctors call Valsalva maneuvers (coughing, sneezing, bearing down, straining while on the toilet)
  • Unintentional great weight loss
  • Weakness or paralysis that lasts after a headache stops

Persons with any of the following problems should go or be taken to a hospital emergency department:

  • The worst headache of a person’s life, especially if the headache comes on suddenly
  • Headache associated with trauma to the head
  • Trauma to the head with loss of consciousness
  • Fever or stiff neck associated with a headache
  • Decreased level of consciousness or confusion
  • Paralysis on one side of the body
  • Seizures
Medically Reviewed by a Doctor on 4/4/2016
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