Four decades of experience with cluster headache: description of a series from a tertiary hospital.

INTRODUCTION

There are practically no series of cluster headache (CH) in our country. Our aim was to longitudinally describe the characteristics of patients with CH seen in our Hospital since 1980.

METHODS

Retrospective analysis of the clinical charts of patients diagnosed as CH.

RESULTS

We included 153 patients diagnosed as CH. 137 (89,5%) males, with a mean age (MA) at diagnosis of 39.5 years (mean deviation 11.4) and a MA at the beginning of the symptoms of 32.8 years (mean deviation 11.3). 128 suffered from episodic CH (eCH; 92.2% males) and 25 chronic CH (cCH; 76% males). The MA at the beginning was delayed in cCH as compared with eCH (37.6 versus 31.8; p = 0.023). Four patients (2.6%) had familial antecedents. Only 3 (2%) referred visual aura. At diagnosis, 66% were smokers and 15% heavy alcohol drinkers. The median duration of cluster period was 60 days, with a median frequency of every 2 years. 16 cases (10.5%) presented a benign course with only one cluster period.

CONCLUSIONS

The minimal prevalence of CH in our area was 0.05%, with eCH being the most frequent phenotype. Up to one out of 10 patients showed a benign form with just one cluster period. The diagnostic delay close to 7 years indicates an insufficient recognition of this entity. A high proportion of CH patients showed, already at diagnosis, unhealthy life habits. Cluster periods lasted an average of 2 months and occurred approximately every 2 years. A late beginning and being a woman were associated with the variant of cCH.