Lecture Notes on Cluster Headaches

Overview

• Speaker: Tom from Zero2Finals.com
• Topic: Cluster headaches
• Resources: Notes available at Zero2Finals.com and in the Zero to Finals Medicine book

Characteristics of Cluster Headaches

• Nature of Pain: Severe, unbearable, unilateral headaches, typically around the eye.
• Occurrence: Termed 'cluster' due to patterns of frequent attacks followed by periods of remission.
  • Example: 3-4 attacks/day for a week or month, then pain-free for 1-2 years.
• Duration of Attacks: 15 minutes to 3 hours.
• Triggers: Alcohol, strong smells, exercise.

Typical Patient Profile

• Demographics: 30-50 year old male smoker.
• Symptoms:
  • Described as 'suicide headaches' due to intense pain.
  • Unilateral symptoms:
    • Red, swollen, watery eye
    • Pupil constriction (miosis)
    • Eyelid drooping (ptosis)
    • Nasal discharge
    • Facial sweating (one side)

Treatment Options

Acute Management

• Aim: Improve symptoms during an attack.
• Medications:
  • Tryptans such as Sumatriptan (injected subcutaneously at onset).
• Other Therapies:
  • High flow 100% oxygen for 15-20 minutes.
    • Note: Oxygen use is a unique exam-relevant fact.

Prophylaxis

• Goal: Prevent the occurrence of cluster headaches.
• Medications:
  • Verapamil
  • Lithium
  • Prednisolone (short course for 2-3 weeks during active cycle).

Additional Resources

• Zero to Finals Website: Notes, illustrations, and test questions for medical school topics.
• YouTube Channel: Subscribe for updates on new videos.
• Blog: Ideas about a career in medicine and success tips.

Study Tips

• Remember the use of oxygen in treating cluster headache symptoms.

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