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1. Cluster headaches can occur up to several times/day for a few weeks before remitting.

2. These become chronic in 10% of patients, more common in men (5:1), tend to occur in the 20-50 year age group, 70% of patients find that alcohol triggers their headache.

3. The pain is unilateral, severe (described as an "ice-pick" or "hot poker"), and perior retro-orbital.

4. It peaks quickly in 5-10 minutes and resolves in an hour or two.

5. Another characteristic feature is nightly recurrence (called the "alarm clock headache"), about 1 to 2 hours after the onset of sleep or several times during the night.

6. The cluster headache recurs regularly each night for 6-12 weeks, followed by complete freedom for many months or even years.


1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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