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Revista Cubana de Medicina

versão impressa ISSN 0034-7523versão On-line ISSN 1561-302X


MAYA ENTENZA, Carlos Manuel; MARTIN LABRADOR, Miladys  e  MONTEAGUDO TORRES, Marisol. Cluster headache: Prospective study of 245 patients. Rev cubana med [online]. 2007, vol.46, n.1. ISSN 0034-7523.

Cluster headache is a type of primary neurovascular headache, poorly diagnosed, with low prevalence and characterized by unilateral pain of great intensity distributed in the trigeminal nerve territory that is accompanied with autonomic symptoms. This research was made to try to establish the prevalence of CH in our environment, clinical characteristics, evolution and treatment of the patients. 245 patients who fulfilled the diagnostic criteria for CH and received attention from 1999 to 2005, including both, were prospectively analyzed. The data collected by survey were the identity of the patient, the sociodemographic aspects, the symptoms and signs on the physical examination, and the treatment. It was proved that the patients with CH accounted for 4 % of all the types of headache. 95.5 % of the patients were males, and 89.4 % were between the 3 rd and the 5 th decades of life. 41.2 % of the patients were professionals Stress was the most frequent risk factor, whereas the episodic CH was the clinical form and the autonomic symptoms were tearing, nasal congestion, rhinorrhea, and conjunctival injection. Facial sweating, psychomotor agitation, palpebral edema, palpebral ptosis, myosis, bradycardia, and diarrheas, were also important. It appeared at night in 190 patients (77.5 %). The average of seizures was 5.3 ± l.9. The episodes occurred during summer in 90.6 % of the individuals. The preventive treatment consisted in lithium carbonate, prednisone, verapamil and lithium carbonate associated with prednisone. The abortive treatment of the crisis in most of the cases was inhalation of oxygen and sumatriptan. It was concluded that CH is the third cause of headache in our setting. The seasonal dynamics is a risk factor for the triggering of the crisis and there are important groups of risk factors for suffering from it. The diagnostic of the disease is poor. The treatment with lithium carbonate prevents the crisis and oxygen and sumatriptan are effective for finishing the episodes.

Palavras-chave : Lithium carbonate; headache; cluster headache; trigeminal headache with autonomic symptoms; hypothalamus; treatment.

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