Cluster Headache
Cluster Headache also known as suicide headache, is defined as an
uncommon distinctive neurovascular syndrome occurring in either episodic
or chronic patterns of that occur
periodically over a long period of time. The diseases affects over 0.1%
of the population, occurring at 45-to 60-day intervals with one to
three headaches a day lasting 45 min to 2 h(a), if untreated it, can
cause increased frequency of the attacks.
A. Misdiagnosis
In a study conducted of Vast Majority of Cluster Headache Patients Are
Initially Misdiagnosed, Dutch Researchers Report of a total of 1163
participants completed and returned the second questionnaire (913 men,
250 women). Only 22% said they were initially diagnosed with CH.
Twenty-one per cent were initially diagnosed with sinusitis, 17% migraine, and 11% with a dental related condition.
Sixteen percent had made the CH diagnosis themselves after reading
about the symptoms. Sixteen percent had undergone tooth extraction and
12% an ears, nose and throat operation as treatment for their headaches
Your health care provider can diagnose this type of headache by
performing a physical exam and asking questions about your symptoms and
medical history, In their report, published in the Journal of Neurology
Neurosurgery and Psychiatry in August 2003, Dr. van Vliet and colleagues
say that clinical symptoms such as sensitivity to light, nausea and
vomiting most likely lead physicians to diagnose migraine even though
they are also common CH symptoms (23)
B. Diagnosis
Diagnosis depending to the symptoms of the diseases, including medical
history, physical exam, pattern of recurrent attacks, and by cardinal
symptoms (swollen eyelid, watery eye, runny nose). Keeping a headache
attacks diary, etc. will help a physician to rule out other types of
headaches. As The attacks are stereotypic--they are of extreme intensity
and short
duration, occur unilaterally, and are associated with robust signs and
symptoms of autonomic dysfunction. Although the pathophysiology of cluster headache remains to be fully understood, there have been a number of recent seminal observation(24)
If a physical exam is done within 48h of last attack, patients who had pain episodes mimicking cluster headache attacks, and who experienced a total or partial Horner's syndrome ipsilaterally to pain (25)
C. Types of diagnosis
The aim of the diagnosis is to rule other causes of the diseases
1. CT scan
CT scan can dive your doctor a three-dimensional view of your blood
vessels of the brain to look for masses and other abnormalities that
cause migraine headache
2. Magnetic resonance imaging (MRI)
By using radio waves and magnetic fields to take pictures, MRI scan
provides very high quality of a cross-sectional slice and lengthwise
slices of the brain and thus providing the better and detail image of
location of tumor and the surrounding structures. It is one of most
likely early test ordered by a doctor to diagnose tumors, strokes,
aneurysms, neurological diseases and other brain abnormalities and the
blood vessels around the brain.
3. Spinal tap (lumbar puncture)
A spinal tap is a procedure performed when a doctor needs to look at the
cerebrospinal fluid (also known as spinal fluid), by inserting a thin
needle between two vertebrae in your lower back to extract a sample. If
your doctor suspects the onset of migraine headache is caused by
inflammation of the membranes and cerebrospinal fluid surrounding your
brain and spinal cord
4. Etc.
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Sources
(a) http://www.ncbi.nlm.nih.gov/pubmed/18047865
(23)
http://web.archive.org/web/20060925093857/http://www.w-h-a.org/wha2/Newsite/resultsnav.asp?color=C2D9F2&idContentNews=595
(24) http://www.ncbi.nlm.nih.gov/pubmed/20352587
(25) http://www.ncbi.nlm.nih.gov/pubmed/17508178
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