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Cluster Headache vs Migraine

Cluster headaches are rare, extremely painful and debilitating headaches that occur in groups or clusters. They often appear during seasonal changes. They are also described as suicide headaches, a reference to the excruciating pain and resulting desperation that has culminated in actual suicide. A migraine is a form of vascular headache. Migraine headache is caused by a combination of vasodilatation (enlargement of blood vessels) and the release of chemicals from nerve fibers that coil around the blood vessels. During a migraine attack, the temporal artery enlarges. (The temporal artery is an artery that lies on the outside of the skull just under the skin of the temple.) Enlargement of the temporal artery stretches the nerves that coil around the artery and cause the nerves to release chemicals. The chemicals cause inflammation, pain, and further enlargement of the artery. The increasing enlargement of the artery magnifies the pain. Comparison chart Cluster Headache Characteristics of pain: Gender predominance: Sensitivity to light or sound: Runny nose and red, watery eye: Location of pain: Stabbing Migraine Deep throbbing and pulsating More common in females

More common in males

Rare

typical

Present

rare

Deep stabbing pain around the temple or the eye Very severe

Pain located near the eye on affected side

Severity of pain:

Ranging from moderate to quite severe long, headache gradually peaks in around 4-24 hrs

Time of onset:

Short; headaches peak within 45 minutes

Cluster Headache Triggers: Nitroglycerin (glyceryl trinitrate), hydrocarbons (petroleum solvents,perfume), Alcohol, napping, etc. Absent

Migraine Bright lights, loud noises, Changes in sleep patterns, exposure to smoke, Skipping meals etc.

Prodromal aura before headache: Nausea or vomiting:

present

Rare

common

Contents

1 Signs and symptoms:

o o o

1.1 Cluster Headaches 1.2 Migraine 1.3 Pain and Other symptoms

2 Prevalence 3 Genetics 4 Triggers

o o

4.1 Cluster Headaches 4.2 Migraine

5 Diagnosis 6 See Also 7 References

Signs and symptoms:

Cluster Headaches

Deep stabbing pain around the temple or the eye which is usually unilateral.

Stuffy or runny nose Tearing or redness in eyes, droopy eyelids

Migraine

Moderate to severe, throbbing head pain. Most commonly one sided pain; less frequently both sides of the head are affected Pain located near the eye on affected side Pain that worsens with physical activity Sensitivity to light and/or sound Nausea or vomiting Debilitating pain that hinders daily activities

Pain and Other symptoms

Pain during cluster headaches is far worse, significantly more severe than a migraine. Cluster headaches are frequently associated with Horner's syndrome, ptosis (drooping eyelids), conjunctival injection (which results in red, watery eyes), lacrimation (tearing), miosis (constricted pupil), eyelid edema, nasal congestion, rhinorrhea (runny nose), and sweating on the affected side of the face. The neck is often stiff or tender in association with cluster headaches afterwards, and jaw and teeth pain are sometimes reported. Sensitivity to light is more typical of a migraine, as is vomiting, but both can be present in some sufferers of cluster headache, although rare. It has been known to strike at the same time each night or morning, often at precisely the same time during the day a week later.

Prevalence While migraines are diagnosed more often in women, cluster headaches are diagnosed more often in men. The male-to-female ratio in cluster headache ranges from 4:1 to 7:1. It primarily occurs between the ages of 20 to 50 years. Genetics First-degree relatives of sufferers are more likely to have the condition than the population at large. Triggers Cluster Headaches

Nitroglycerin (glyceryl trinitrate)

Alcohol Hydrocarbons (petroleum solvents, perfume) Heat and napping may also act as a trigger. Significant change in sleep or work schedules, with resulting decrease in sleep and REM

Migraine According to the National Library of Medicine's Medical Encyclopedia, Migraine attacks may be triggered by:

Allergic reactions Bright lights, loud noises, and certain odors or perfumes Changes in sleep patterns Smoking or exposure to smoke Skipping meals Alcohol Menstrual cycle fluctuations, birth control Foods containing tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs, and salami) Other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products, and fermented or pickled foods

Diagnosis The diagnosis of migraine without aura, according to the International Headache Society, can be made according to the following criteria, the "5, 4, 3, 2, 1 criteria":

5 or more attacks 4 hours to 3 days in duration 2 or more of - unilateral location, pulsating quality, moderate to severe pain, aggravation by or avoidance of routine physical activity 1 or more accompanying symptoms - nausea and/or vomiting, photophobia, phonophobia

See Also

Migraine vs Tension Headache Cluster Headache vs Tension Headache

References

Harrisons Principles of Internal Medicine (1998 edition) Current Medical Diagnosis and treatment 2004 , Lange publications http://en.wikipedia.org/wiki/Cluster_headache http://en.wikipedia.org/wiki/Migraine http://healthlink.mcw.edu/article/946414636.html http://www.medicinenet.com/cluster_headaches/article.htm http://healthblog.ctv.ca/blog/_archives/2007/8/28/3189973.html

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Migraine vs Tension Headache

A migraine is a form of vascular headache. Migraine headache is caused by a combination of vasodilatation (enlargement of blood vessels) and the release of chemicals from nerve fibers that coil around the blood vessels. During a migraine attack, the temporal artery enlarges. (The temporal artery is an artery that lies on the outside of the skull just under the skin of the temple.) Enlargement of the temporal artery stretches the nerves that coil around the artery and cause the nerves to release chemicals. The chemicals cause inflammation, pain, and further enlargement of the artery. The increasing enlargement of the artery magnifies the pain. Tension Headaches accounts for nearly 90% of all headaches and is probably experienced by most people at some time during their lifetime; frequently associated with fatigue and stress and generally responding to simple measures such as rest or over-the-counter pain medicine; pain usually occurs on both sides of head and consists of a dull, steady ache. Comparison chart All attributes Differences Similarities Migraine Characteristics of pain: Deep throbbing and pulsating Tension Headache Dull and pressure-like pain in the head. It may also produce a feeling of pressure similar to the sensation caused by the placement of a vice or a tight band on the head and/or around the neck.

Migraine Gender predominance: Sensitivity to light or sound: Runny nose and red, watery eye: Location of pain: More common in females

Tension Headache More common in females

typical

Rare

rare

Absent

Pain located near the eye on affected side

The pain is typically generalized, with areas of more intense pain in the scalp, forehead, temples or the back of the neck. Mild to moderate in severity Pain develops gradually, fluctuates in severity and then can remain for several days Stress

Severity of pain:

Ranging from moderate to quite severe long, headache gradually peaks in around 4-24 hrs

Time of onset:

Triggers:

Bright lights, loud noises, Changes in sleep patterns, exposure to smoke, Skipping meals etc. present

Prodromal aura before headache: Nausea or vomiting:

Absent

common

Rare

Contents

1 Signs and Symptoms

o

1.1 Tension-type headache 1.2 Migraine

2 Prevalence
o o

2.1 Frequency 2.2 Gender predominance

3 Triggers
o o

3.1 Migraine 3.2 Tension Headaches

4 Diagnosis
o o

4.1 Migraine 4.2 Tension headaches

5 See Also 6 References

Signs and Symptoms

Tension-type headache

Duration of 30 minutes to 7 days. No nausea or vomiting (anorexia may occur). Photophobia and/or phonophobia. Minimum of 10 previous headache episodes; fewer than 180 days per year with headache to be considered infrequent. Bilateral and occipitonuchal or bifrontal pain. Pain described as "fullness," "tightness/squeezing," "pressure," or "bandlike/viselike". May occur acutely under emotional distress or intense worry. Insomnia. Often present upon rising or shortly thereafter.

Muscular tightness or stiffness in neck, occipital, and frontal regions. Duration of more than 5 years in 75% of patients with chronic headaches. Difficulty concentrating. No prodrome.

Migraine

Throbbing or pulsating headache on one side of your head. Moderate to severe headache intensity. Worsening of your headache with routine physical activity. Nausea, vomiting, or both. Sensitivity to light and noise, and sometimes smells.

Prevalence Frequency In the US: Headache is the ninth most common reason for a patient to consult a physician. Physicians classify 90% of headaches reported to them as muscle contraction or migraine headaches. Internationally: No literature suggests that headache frequency is different in other regions of the world. Gender predominance A female preponderance exists in both Migraine and tension headaches. Triggers Migraine According to the National Library of Medicine's Medical Encyclopedia, Migraine attacks may be triggered by:

Allergic reactions Bright lights, loud noises, and certain odors or perfumes Physical or emotional stress Changes in sleep patterns Smoking or exposure to smoke Skipping meals Alcohol or caffeine

Menstrual cycle fluctuations, birth control pills Tension headaches Foods containing tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs, and salami) Other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products, and fermented or pickled foods

Tension Headaches

Stress - Usually occurs in the afternoon after long stressful work hours Sleep deprivation Uncomfortable stressful position and/or bad posture Irregular meal time (hunger) Eyestrain

Diagnosis Migraine The diagnosis of migraine without aura, according to the International Headache Society, can be made according to the following criteria, the "5, 4, 3, 2, 1 criteria":

5 or more attacks 4 hours to 3 days in duration 2 or more of - unilateral location, pulsating quality, moderate to severe pain, aggravation by or avoidance of routine physical activity 1 or more accompanying symptoms - nausea and/or vomiting, photophobia, phonophobia

Tension headaches 1. By clinical signs and symptoms 2. Lab Studies: 1. Laboratory work should be unremarkable in cases of tension-type headache. Specific tests should be obtained if the history or physical examination suggests another diagnostic possibility. 2. Head CT scan or MRI is necessary only when the headache pattern has changed recently or neurologic examination reveals abnormal findings. Such history or physical exam evidence would suggest an alternate cause of headache.

References

http://en.wikipedia.org/wiki/Migraine#Epidemiology http://en.wikipedia.org/wiki/Tension_headaches http://www.diagnose-me.com/cond/C144796.html http://www.webmd.com/migraines-headaches/tc/migraine-headaches-topic-overview http://www.emedicine.com/EMERG/topic231.htm http://yourtotalhealth.ivillage.com/tension-headache.html? Harrisons Principles of Internal Medicine (15th edition) Current Medical Diagnosis and treatment 2004 , Lange publications

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