A cluster headache can be diagnosed when certain clinical features are present.


Criteria - all of the following:

(1) severe, unilateral pain lasting 15-180 minutes if untreated and located at one or more of the following regions:

(1a) orbital

(1b) supraorbital

(1c) temporal

(2) one or more of the following is/are associated with the headache and on the same side:

(2a) conjunctival injection

(2b) lacrimation

(2c) nasal congestion

(2d) rhinorrhea

(2e) forehead and facial sweating

(2f) miosis

(2g) ptosis

(2h) eyelid edema

(3) at least 5 attacks fulfilling the criteria listed above

(4) frequency of attacks ranges from 1 every other day to 8 per day

(5) one of the following:

(5a) There are no other headache disorders that could explain the findings.

(5b) If the patient is at risk for a secondary headache, then there is evidence (history, physical examination, neurologic examination) that these are not causing the cluster headache.

(5c) If the patient does have a headache secondary to another cause, then the cluster headache does not occur for the first time in close temporal relation to that disorder.



• The definition for the fifth criteria refers to headaches in groups "5-11", which is based on the listing of headache conditions in the article. These are: head trauma, vascular disorder, nonvascular intracranial disorder, substance withdrawal, non-cephalic infection, metabolic disorder, and physical disorder of head and neck.


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