Cluster headache (CH) as one of the most disabling primary headache disorders is considered underdiagnosed and often inappropriately treated. We aimed to assess characteristics of patients with CH referred to our tertiary headache center, and to compare those to patients with migraine.
This analysis is part of a cross-sectional study conducted at the Headache Center of the Charité – Universitätsmedizin Berlin between December 2015 and January 2023. All patients who came for their first visit were asked to complete an anamnesis questionnaire including data on disease duration, comorbities, and prior treatments. Moreover, we collected Patient-Reported Outcome Measures (PROMs), using the Headache Impact Test (HIT-6), the Depression, Anxiety and Stress Scale 21 (DASS-21), and the Short Form 12 (SF-12). We compared characteristics of patients diagnosed with CH to patients with migraine matched for age and sex.
Of 1468 patients presenting for the first time at our tertiary headache center (43 ± 14 years; 74.5% women), 56 (44 ± 9 years; 23.2% women) were diagnosed with CH. Compared to patients with migraine, patients with CH had a shorter disease duration from onset to referral (5.5 [7.3] years vs. 18.0 [16.8] years, p <0.001), but the same number of prior treatment attempts for acute and preventive medication (2 [2] vs. 2 [1], p=0.337 and 1 [2] vs. 1 [2], p=0.675, respectively). Smoking and illicit drug use were more frequent among patients with CH (51.8% vs. 19.6, p<0.001 and 30.4% vs. 7.1%, p=0.003, respectively). PROMs scores did not differ significantly.
These results indicate an adequate medical attention for CH among referring physician to a tertiary headache center. A higher prevalence of lifestyle risk factors among CH patients warrants further research on a possible role for development or exacerbation of CH and preventive measures.