Tension headaches and Cluster headaches

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While tension headaches are the most frequently occurring type of headache, the cause is most likely contraction of the muscles that cover the skull. When the muscles covering the skull are stressed, they may spasm and cause pain. Common sites include the base of the skull, the temple and the forehead. Tension headaches occur because of physical or emotional stress placed on the body.


  • The pain begins in the back of the head and upper neck and is described as a band-like tightness or pressure. 
  • Often is described as pressure encircling the head with the most intense pressure over the eyebrows. 
  • The pain usually is mild (not disabling) and bilateral (affecting both sides of the head). 
  • The pain is not associated with an aura, nausea,vomiting, or sensitivity to light and sound. 
  • The pain occurs sporadically (infrequently and without a pattern) but can occur frequently and even daily in some people. 
  • The pain allows most people to function normally, despite the headache

  1. The key to making the diagnosis of any headache is the history given by the patient 
  2. If the health care practitioner finds an abnormality, then the diagnosis of tension headache would not be considered until the potential for other types of headaches have been investigated.

Cluster headaches

Cluster headaches are headaches that come in groups (clusters) lasting weeks or months, separated by pain-free periods of months or years. The cause of cluster headaches is uncertain. Some evidence shows that brain scans performed on patients who are in the midst of a cluster headache, shows abnormal activity in the hypothalamus. Cluster headaches:
  • May tend to run in families and this suggests that there may be a genetic role
  • May be triggered by changes in sleep patterns
  • May be triggered by medications (for example, nitroglycerin)
If an individual is in a susceptible period for cluster headache, cigarette smoking, alcohol, and some foods (for example, chocolate) also can be potential causes for headache.


  1. Pain typically occurs once or twice daily and last for 30 to 90 minutes 
  2. Attacks tend to occur at about the same time every day 
  3. The pain typically is excruciating and located around or behind one eye. 
  4. The affected eye may become red, inflamed, and watery
Note:  Cluster headaches are much more common in men than women.

Prevention cluster headaches

Since cluster headache episodes may be spaced years apart, and since the first headache of a new cluster episode can't be predicted, daily medication may not be warranted.

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