When cluster headache does not go away

Cluster headache is usually recognised by a distinctive pattern of severe one-sided attacks, often around the eye, with tearing, nasal blockage or discharge, eyelid changes, and restlessness. A headache that remains continuously present, lasts longer than expected for you, or changes in quality may need a fresh diagnosis and examination. Other headache, eye, sinus, medication-related, or neurological problems can resemble part of this pattern, so persistent pain should not be explained by the label alone.

Write down whether the pain ever fully settles between attacks. Also note fever, visual change, weakness, vomiting, neck stiffness, recent injury, and all medicines taken. These details help a clinician judge urgency and reduce the risk of repeating an unsuitable treatment.

Contact a GP consultation service promptly for a continuing or changed headache. Take your diary, medicine packets or names, and any previous diagnosis or treatment instructions. Follow only the prescribed dosing plan; taking repeated doses of pain medicine without advice can create additional problems. Rest in a safe environment, avoid driving if pain or vision symptoms impair you, and ask someone to stay available if you feel unwell. If an established rescue plan is failing, tell the clinician exactly when it was used and what happened afterward. Do not borrow another person's medicine or oxygen equipment.

Call emergency services for a sudden severe headache, new weakness or numbness, confusion, collapse, seizure, difficulty speaking, persistent vision loss, fever with a stiff neck, or a painful red eye with reduced vision. Seek urgent assessment for repeated vomiting, a new headache after injury, or pain that is rapidly worsening. If you are unsure whether a warning sign is present, use urgent medical advice rather than waiting for the next routine appointment.

Does the continuous pattern fit cluster headache, or should we check another cause? Which examination or tests are appropriate? What should I do when the current plan fails? Which symptoms require emergency care, and how can I avoid medication-overuse problems?