ABSTRACT
Trigeminal autonomic cephalalgias (TACs) consist of a group of headache syndromes usually marked by cyclical episodes of severe head pain with cranial autonomic activation. Cluster headache is the most common of the TACs; while rare relative to other primary headaches, its prevalence is similar in northern climates to multiple sclerosis. The key pathophysiological processes of cluster headache take place within the central nervous system. Pharmacological treatment for cluster headache can be abortive, or a combination of both methods. Dihydroergotamine (DHE), available in injectable and intranasal forms, is effective in relieving acute attacks of cluster headache. Non-parenteral analgesics and narcotics have little role in the treatment of cluster headache, although they may be useful for some patients who are unresponsive to oxygen and have ischemic heart disease. Local steroid and anesthetic injection of the ipsilateral greater occipital nerve has been reported to be effective in cluster headache.
