Diagnosis and Treatment of Hemicrania Continua and Cluster Headache

Diagnostic Criteria

Cluster headache features strictly unilateral, severe pain lasting 15-180 minutes, with prominent ipsilateral autonomic symptoms including lacrimation, nasal congestion, and ptosis, according to Praxis Medical Insights 1
Secondary headache causes should always be ruled out before confirming either diagnosis, as recommended by Praxis Medical Insights 1

Acute treatment of cluster headache includes normobaric oxygen therapy (100% oxygen at flow rates of at least 12 L/min for 15 minutes) and subcutaneous sumatriptan (6 mg) or intranasal zolmitriptan (10 mg), as suggested by Annals of Internal Medicine 3 and Praxis Medical Insights 2
Galcanezumab is recommended as first-line prophylactic treatment for episodic cluster headache, according to Praxis Medical Insights 2
Noninvasive vagus nerve stimulation is suggested for short-term treatment of episodic cluster headache, as recommended by Annals of Internal Medicine 3
Cluster headache is often triggered by alcohol and strong smells, according to Praxis Medical Insights 2