Tension and Cluster Headache

Tension headache

This tends to be described as a gradual band-like tightness around the head that resolves gradually. It's associated with:

• Stress

• Dehydration

• Depression

• Alcohol

Management:

• Reassurance

• Basic analgesia

• Relaxation techniques

Cluster headache

This presents as recurrent attacks of sudden-onset unilateral periorbital pain, associated with lacrimation, rhinorrhoea, and a bloodshot eye. These attacks tend to last 15 mins to 3 hours each day, over a period of 4-12 weeks, and is followed by a pain-free period of months before the next cluster begins.

Management:

• Acute attack - HF O2 +/- SC/Nasal Sumitriptan

• Prophylaxis - Verapamil