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Causes
By Mayo Clinic staffThe exact cause of cluster headaches is unknown, but abnormalities in the hypothalamus likely play a role. Cluster attacks typically occur with clocklike regularity during a 24-hour day, and the cycle of cluster periods often follows the seasons of the year. These patterns suggest that the body's biological clock is involved. In humans, the biological clock is located in the hypothalamus, which lies deep in the center of your brain. Abnormalities of the hypothalamus may explain the timing and cyclical nature of cluster headache. Studies have detected increased activity in the hypothalamus during the course of a cluster headache.
Other factors that may be involved in the development of cluster headaches include:
- Hormones. People who have cluster headaches have abnormal levels of certain hormones, such as melatonin and cortisol, during cluster periods.
- Neurotransmitters. Changes in the levels of some of the chemicals that carry impulses in the brain (neurotransmitters), such as serotonin, may play a role in the development of cluster headaches.
Unlike migraine and tension headache, cluster headache generally isn't associated with triggers such as foods, hormonal changes or stress. But once a cluster period begins, consumption of any alcohol can quickly trigger a splitting headache. For this reason, many people with cluster headache avoid alcohol for the duration of a cluster period. Other possible triggers include the use of medications such as nitroglycerin, a drug used to treat heart disease.
- Bajwa ZH, et al. Patient information: Headache causes and diagnosis in adults. http://www.uptodate.com/home/index.html. Accessed Dec. 19, 2008.
- Goetz CG. Headache. In: Goetz CG. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/115317111-2/787037600/1488/451.html. Accessed Dec. 29, 2008.
- Leroux E, et al. Cluster headache. Orphanet Journal of Rare Diseases. 2008;3:20.
- Headache: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/headache/detail_headache.htm?css=print. Accessed Dec. 29, 2008.
- Bajwa ZH, et al. Approach to the patient with headache syndromes other than migraine. http://www.uptodate.com/home/index.html. Accessed Dec. 19, 2008.
- Treatment of primary headache: Cluster headache. National Guideline Clearinghouse. http://www.guideline.gov/summary/summary.aspx?doc_id=6582&nbr=004142&string=clus. Accessed Jan. 2, 2009.
- Bajwa ZH, et al. Patient information: Headache treatment in adults. http://www.uptodate.com/home/index.html. Accessed Dec. 19, 2008.
- Magis D, et al. Neurostimulation in Chronic Cluster Headache. Current Pain and Headache Reports. 2008;12:145.
- Rossi P, et al. Use of complementary and alternative medicine by patients with cluster headache: Results of a multi-centre headache clinic survey. Complementary Therapies in Medicine 2008;16:220.
- Swanson JW (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 12, 2009.
