Cluster headache differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saumya Easaw, M.B.B.S.[2]

Differential Diagnosis of Cluster headache

Cardiovascular	• Acute hypertension • Cerebral venous thrombosis • Interior carotid artery dissection •
Chemical / poisoning	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	No underlying causes
Ear Nose Throat	• Sinusitis •
Endocrine	• Pheochromocytoma •
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	• Herpes Zoster •
Musculoskeletal / Ortho	No underlying causes
Neurologic	• Chronic paroxysmal hemicrania (CPH) • Subarachnoid hemorrhage • Trigeminal Neuralgia • Cyclical migraine • Hemicrania continua • Intermittent hydrocephalus • Sleep apnea •
Nutritional / Metabolic	No underlying causes
Obstetrics and Gynecology	• Preeclampsia •
Oncologic	• Intracranial neoplasm •
Opthalmologic	• Acute optic neuritis • Acute glaucoma •
Overdose / Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	• Temporal Arteritis • Allergen exposure • Connective tissue disorder (e.g., systemic lupus erythematosus SLE) •
Trauma	• Cranial trauma •
Miscellaneous	No underlying causes

Chronic Paroxysmal Hemicrania (CPH) is a condition similar to cluster headache, but CPH responds well to treatment with theanti-inflammatory drug indomethacin and the attacks are very much shorter, often lasting only seconds.^[1]

Some people with extreme headaches of this nature (especially if they are not unilateral) may actually have an ictal headache. Anticonvulsant medications can significantly improve this condition so sufferers should consult a physician about this possibility.^[2]

It is also possible to have two or more different types of headaches, complicating diagnosis and treatment.