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Chronic Cluster Headaches

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Abstract

Chronic cluster headache is defined in the ICHD-3 as cluster attacks occurring for more than 1 year without remission or with remission periods lasting less than 1 month. The author presents a narrative review of current literature on chronic cluster headaches, a rare form of trigeminal autonomic cephalalgias in which attacks occur without remission for over a year. I will summarize current knowledge on diagnostic criteria, differential diagnosis, pathophysiology, and management of chronic cluster headaches, an extremely disabling disorder. Generally, there is a delay in diagnosis of more than 6 years in recognizing this type of headache. Little is known about the pathogenesis of these headaches, though with newer functional imaging modalities, we are closer to understanding whether the hypothalamus and suprachiasmatic nucleus are involved, as in episodic cluster. In addition, newer therapies including sphenopalatine ganglion and vagus nerve stimulators are emerging, making early recognition of these disorders more clinically relevant.

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Authors and Affiliations

  1. Clinical Professor of Neurology, Keck school of Medicine, Los Angeles, CA, USA

    Soma Sahai-Srivastava

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  1. Soma Sahai-Srivastava
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  1. Department of Headache and Pain Medicine, Icahn School of Medicine at Mt. Sinai, Department of Headache and Pain Medicine, New York, NY, USA

    Mark W. Green

  2. Neurology & Neurological Sciences, Stanford School of Medicine Neurology & Neurological Sciences, Stanford, CA, USA

    Robert Cowan

  3. Department of Neurology, Medical College of Wisconsin, Department of Neurology, Milwaukee, WI, USA

    Frederick G. Freitag

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Sahai-Srivastava, S. (2019). Chronic Cluster Headaches. In: Green, M., Cowan, R., Freitag, F. (eds) Chronic Headache. Springer, Cham. https://doi.org/10.1007/978-3-319-91491-6_6

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