Hello and welcome to the Zero to Finals podcast. My name is Tom, and in this episode I'm going to be talking to you about Cluster Headaches.

And you can follow along with written notes on this topic at zero tofinals.com slash cluster headaches,

or in the neurology section of the Zero to finals medicine book. So let's get straight

into it. Cluster headaches cause severe and unbearable unilateral headaches usually around the eye.

And they're called cluster headaches because they come in clusters of attacks and then disappear

for a while. For example, a patient might have three to four

attacks a day for a week or month, followed by a pain-free period lasting one to two years.

Attacks last between 15 minutes and three hours, and they can be triggered by things like

alcohol, strong smells or exercise. A typical patient that you might see in your exams who's got cluster headaches is a 30 to 50 year old male smoker

coming in with severe pain around one eye.

So what are the symptoms?

Cluster headaches are often described as the most severe and intolerable pain in the world.

They're sometimes referred to as suicide headaches due to the severity of the pain.

And symptoms are all typically unilateral with a red swollen and watery eye,

pupil constriction, which is called meiosis, eyelid drooping, which is called tosis, nasal discharge,

and there can be facial sweating on one side. So what are the treatment options for cluster

headaches? Well, there's the acute management, which aims to improve the symptoms of the

cluster headache at the time.

And this can be with triptans, for example, sumatriptan injected subcutaneously at the start of the headache.

Another option which often comes up in exams is high flow 100% oxygen,

which is breathed for 15 to 20 minutes to try and improve the symptoms of the

headache. And patients are often given oxygen to keep at home to use during the headaches

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