Your patient is not so young anymore and female. Her headache is not perfectly Cluster (now continuous for 3 days), yet it started out fairly typical. Then someone comes by, insufflates some oxygen, she gets better and bang – it has to be Cluster.
Even if you don’t believe in the all primary headaches are spreading depression slogan, you would be surprised if success of oxygen therapy were specific for Cluster headache. Here is a paper that shows some benefit for all primary headaches in an ER.
In today’s session we review Cluster headache and the other trigeminovascular headaches I know (not too many), using
Remember there are some ophthalmologic differentials for cluster:
- orbital infection/imflammation