University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, PA 15232, USA. Jackie.
Am Fam Physician. 2013 Jul 15;88(2):122-8.
Cluster headache causes severe unilateral temporal or periorbital pain, lasting 15 to 180 minutes and accompanied by autonomic symptoms in the nose, eyes, and face. Headaches often recur at the same time each day during the cluster period, which can last for weeks to months. Some patients have chronic cluster headache without remission periods. The pathophysiology of cluster headache is not fully understood, but may include a genetic component. Cluster headache is more prevalent in men and typically begins between 20 and 40 years of age. Treatment focuses on avoiding triggers and includes abortive therapies, prophylaxis during the cluster period, and long-term treatment in patients with chronic cluster headache. Evidence supports the use of supplemental oxygen, sumatriptan, and zolmitriptan for acute treatment of episodic cluster headache. Verapamil is first-line prophylactic therapy and can also be used to treat chronic cluster headache. More invasive treatments, including nerve stimulation and surgery, may be helpful in refractory cases.
丛集性头痛导致严重的单侧颞部或眶周疼痛，持续 15 至 180 分钟，并伴有鼻、眼和面部自主症状。头痛常在丛集期的每天同一时间反复发作，持续数周至数月。一些患者患有慢性丛集性头痛，无缓解期。丛集性头痛的病理生理学尚未完全阐明，但可能包括遗传成分。丛集性头痛在男性中更为常见，通常在 20 至 40 岁之间开始。治疗侧重于避免触发因素，包括发作期的中止治疗、丛集期的预防治疗以及慢性丛集性头痛患者的长期治疗。有证据支持补充氧气、舒马曲坦和佐米曲坦用于发作性丛集性头痛的急性治疗。维拉帕米是一线预防治疗药物，也可用于治疗慢性丛集性头痛。更具侵袭性的治疗方法，包括神经刺激和手术，在难治性病例中可能有帮助。
