Cluster Headache 4

Therapy

There is no treatment to cure cluster headache. The goal of treatment is to help decrease the severity of pain and shorten the term of the attack. Drugs that are used for cluster headache can be divided into symptomatic medications and prophylactic. Obta-symptomatic medication intended to stop or reduce pain after a cluster headache attack, while prophylactic medications used to reduce exacerbation frequency and intensity of headaches.Because this type of headache is increasing rapidly symptomatic treatment should have the nature of work quickly and can be given promptly, usually using inhalers instead of injections or tablets by mouth.Symptomatic treatment including:1. Oxygen. Inhalation of 100% oxygen through a face shield with a capacity of 7 liters / min gives a good recovery in 50 to 90% of people who use it. Sometimes larger amounts can be more effective. The effect of the use is relatively safe, inexpensive, and the effect can be felt after about 15 minutes. The main disadvantage of this is the use of oksdigen patients have to carry around an oxygen tank and governing, making the treatment in this way to be uncomfortable and can not be accessed any time. Sometimes oxygen may only delay rather than stop the attack and the pain will return.2. Sumatriptan. Sumatriptan injection drug commonly used to treat migraine, is also effectively used in cluster headache. Some people benefit from the use of sumatriptan in the form of a nasal spray, but more research is still needed to determine its effectiveness.3. Ergotamine. This ergot alkaloids cause vasoconstriction in the smooth muscles in the blood vessels of the brain. Available in the form of injections and inhalers, use of intra-venous works faster than the inhaler dosage should be limited to prevent the occurrence of side effects, especially nausea, as well as caution in patients with a history of hypertension.4. Local anesthetic medications. A local anesthetic that stabilizes the neuronal membrane of nerve cells become less permeable to ions. This prevents the formation and delivery of nerve impulses, causing a local anesthetic effect. Intra-nasal lidocaine can be used effectively in cluster headache attacks. But be careful if used in patients with hypoxia, respiratory depression, or bradycardia.Prophylactic medications:1. Anticonvulsants. The use of prophylactic anticonvulsants in cluster headache has been demonstrated in several studies is limited. Mechanism of action of these drugs to prevent cluster headache remains unclear, it may work by regulating central pain sensitization.2. Corticosteroids. Corticosteroid medications are very effective at removing cluster headache cycle and prevent recurrence soon. High doses of prednisone next few days diving down slowly. Mechanism of action of corticosteroids in cluster headache is still unknown.SurgerySurgery is recommended in people with chronic cluster headaches that do not respond well to treatment or to people who have a contraindication to the use of drugs. Someone who will undergo surgery merely that had a lump on one side only because this operation can only be done once. People who experience a move from one side to the other at risk of failure.There are several types of surgery that can be done to treat cluster headache. Procedure is destructive neural pathways responsible for pain.Nerve block invasive neurosurgical procedures or non-invasive (eg radio frequency pericutaneus, gangliorhizolisis trigeminal, rhizotomi) has been proven to successfully treat cluster headache. However, side effects such as facial diastesia, sensory loss in the cornea and anesthesia dolorosa.Surgery using gamma rays are now more often used as a less invasive. The new method is a promising and stimulating electrode implantation using stereostatik signpost at the inferior hypothalamus. Research has shown that stimulation of the hypothalamus in cluster headache patients with severe provide a complete cure and no significant side effects.PreventionBecause the cause of cluster headaches is still not known with certainty we have not been able to prevent the first attack. But we can prevent headaches replicates heavier. The use of preventive medications over the long term than the short-term benefit. Preventive medications long term include calcium channel blockers and channel carbonate. Sedangakan the short term including the corticosteroids, ergotamine and local anesthetic drugs.Avoid alcohol and nicotine, and other risk factors can help reduce the occurrence of attacks.9. Prognosis• 80% of patients with cluster headache recurring tend to have recurrent attacks.• type of episodic cluster headache can turn into a chronic type sampai13 in 4% of patients.• Spontaneous Remission and durable occurred in 12% of patients, especially in the type of episodic cluster headache.• Most cluster headache is a lifelong problem.• The onset of this disorder teruama up in men with a history of episodic cluster headache types have a worse prognosis.

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