Daily Bolus of LR: Tension and Cluster Headaches

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September 23, 2011 by dailybolusoflr

Tension headaches

·         Have a lifetime prevalence of as high as 78% of the general population

·         Are the most common type of primary headache * (see below for definition)

·         Usually are mild

·         Typically consist of bilateral, band-like or squeezing pain which affects the head and/or neck

·         Are not usually associated with additional symptoms such as nausea, vomiting or worsening with physical activity

·         Physical examination often has focal points of tenderness, but otherwise is normal

·         Treatment: over the counter medications, such as acetaminophen or ibuprofen, in conjunction with stress relief activities


Cluster headache

·         The only headache which is more common in men than women

·         Typically seen in young-middle aged smokers

·         Tend tend to come in “clusters” and are recurrent, often with multiple episodes in one day

·         Typically consist of unilateral throbbing pain affecting the eye and its surrounding area

·         Physical examination may reveal unilateral conjunctival injection, nasal congestion, lacrimation, or rhinnorhea

·         30% of patients may also have a partial Horner’s syndrome (miosis and ptosis)

·         Treatment: may be successfully aborted with sumatriptan and/or high flow oxygen



*Note: Primary headaches have no identifiable underlying cause vs. secondary headaches- or organic headaches- which are those with an underlying structural etiology.


Ref: Roberts and Hedges, 5th ed

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