Resumo
Definição
Anamnesis y examen
Principales factores de diagnóstico
- presence of risk factors
- repeated attacks of unilateral pain
- short duration
- excruciating pain
- lacrimation, rhinorrhoea, and partial Horner syndrome
- agitation and restlessness
Factores de riesgo
- male sex
- family history
- head injury
- cigarette smoking
- heavy drinking
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- brain and pituitary MRI without and with intravenous contrast
- erythrocyte sedimentation rate
Pruebas diagnósticas que deben considerarse
- pituitary function tests
- magnetic resonance angiography (MRA) head and neck with and without contrast
- brain CT scan
- polysomnogram
- ECG
Algoritmo de tratamiento
acute attack: without cardiovascular disease, cerebrovascular disease, or uncontrolled hypertension
acute attack: with cardiovascular disease, cerebrovascular disease, or uncontrolled hypertension
preventative treatment for episodic cluster headache
preventative treatment for chronic cluster headache
Colaboradores
Autores
Juliana VanderPluym, MD, FRCPC, FAHS
Associate Professor of Neurology
Department of Neurology
Mayo Clinic Arizona
Scottsdale
AZ
Divulgaciones
JVP has received a research grant from Amgen. She has previously acted as a consultant for Teva and is on the editorial board of the American Migraine Foundation. JVP is a co-editor of the Headache section for Current Neurology and Neuroscience Reports.
Amaal J. Starling, MD
Associate Professor of Neurology
Department of Neurology
Mayo Clinic Arizona
Scottsdale
AZ
Disclosures
AJS serves on the Board of Directors for the American Headache Society, the Alliance for Headache Disorders Advocacy, and the United Council for Neurologic Subspecialties. AJS has received consulting fees from AbbVie, Allergan, Amgen, Axsome Therapeutics, Eli Lilly & Company, Everyday Health, Impel, Lundbeck, Med-IQ, Medscape, Neurolief, Novartis, Satsuma, Teva, and Theranica. None are directly related to the topic of cluster headache.
Christoper C. Anderson, MD
Headache Medicine Fellow Physician
Mayo Clinic Arizona
Scottsdale
AZ
Disclosures
CCA declares that he has no competing interests.
Acknowledgements
Dr Juliana VanderPluym, Dr Amaal J. Starling, and Dr Christopher C. Anderson would like to gratefully acknowledge Dr Sarah Miller, Dr Alok Tyagi, Dr Manjit S. Matharu, Dr Marc S. Husid, and Dr Davis L. Mellick, previous contributors to this topic.
Disclosures
SM received an educational grant from St Jude Medical and Medtronic, and received payment for educational presentations from Allergan and Autonomic Technologies, Inc. AT was on advisory boards for Allergan and electroCore, and received organisational payments from eNeura, Allergan, and electroCore. MSM served on the advisory board for Allergan, St Jude Medical, and Medtronic, and received payment for the development of educational presentations from Allergan, MSD, Medtronic, and electroCore. MSH and DLM declare that they have no competing interests.
Peer reviewers
Mark W. Green, MD, FAAN
Director of Headache and Pain Medicine
Professor of Neurology, Anesthesiology, and Rehabilitation Medicine
Icahn School of Medicine at Mount Sinai
New York
NY
Disclosures
MWG declares that he has no competing interests.
Anne Walling, MD
Professor
Family and Community Medicine
University of Kansas School of Medicine
Wichita
KS
Disclosures
AW declares that she has no competing interests.
Christian Lampl, MD, PhD
Department Head
Department of Neurology and Pain Medicine
Konventhospital Barmherzige Brüder Linz
Linz
Austria
Declarações
CL declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Schindler EAD, Burish MJ. Recent advances in the diagnosis and management of cluster headache. BMJ. 2022 Mar 16;376:e059577. Resumo
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211.Texto completo Resumo
American College of Radiology. ACR appropriateness criteria: headache. 2022 [internet publication].Texto completo
Robbins MS, Starling AJ, Pringsheim TM, et al. Treatment of cluster headache: the American Headache Society evidence-based guidelines. Headache. 2016 Jul;56(7):1093-106.Texto completo Resumo
Law S, Derry S, Moore RA. Triptans for acute cluster headache. Cochrane Database Syst Rev. 2013 Jul 17;(7):CD008042.Texto completo Resumo
May A, Evers S, Goadsby PJ, et al. European Academy of Neurology guidelines on the treatment of cluster headache. Eur J Neurol. 2023 Oct;30(10):2955-79.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Migraine
- Paroxysmal hemicrania
- Short-lasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)
Mais Diagnósticos diferenciaisDiretrizes
- Headaches in over 12s: diagnosis and management
- European Academy of Neurology guidelines on the treatment of cluster headache
Mais DiretrizesFolhetos informativos para os pacientes
Cluster headaches: what are they?
Cluster headaches: what treatments are available?
Mais Folhetos informativos para os pacientesConectar-se ou assinar para acessar todo o BMJ Best Practice
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