What causes cluster headaches?

Cluster headache involves activation of pathways that carry pain from the face and head, with changes in nearby blood vessels and automatic nerve functions. The hypothalamus, a brain region involved in sleep and daily rhythms, may help explain why attacks can arrive at similar times or disturb sleep. During an active bout, alcohol, strong smells, heat, or exertion can trigger an attack for some people, but triggers do not explain the underlying condition. A headache symptom can have many causes, so the pattern needs proper assessment.

Keep an attack diary rather than trying to avoid every ordinary activity. Note sleep, timing, alcohol, smells, heat, exertion, medicines, and how quickly symptoms developed. Avoid a trigger that repeatedly precedes an attack, particularly during an active bout. Make a GP consultation appointment to review the pattern and discuss treatments that interrupt attacks or reduce their return. A diary can also reveal whether the pain is changing.

Call emergency services for a sudden maximal headache, weakness, speech trouble, confusion, collapse, seizure, fever with a stiff neck, or new visual loss. Seek urgent assessment for a painful red eye with changed vision. Arrange prompt review for a first cluster-like episode, a new pattern after injury, or headache during pregnancy. Repeated attacks still require diagnosis even when a familiar trigger seems present.

Does my timing and symptom pattern fit cluster headache? Which triggers should I avoid, and for how long? Could another condition mimic this pain? What treatment should I start if another attack occurs?