Four decades of experience with cluster headache: description of a series in a University Hospital of Spain

Abstract

Background: There are few published series of cluster headache. Our aim was to longitudinally describe the epidemiological and clinical features of cluster headache patients in our region since 1980.Methods: Retrospective analysis of the clinical charts of patients diagnosed as cluster headache in a Spanish tertiary hospital.Results: 153 patients were included. 137 (89,5%) were males. Mean age at the beginning of symptoms and diagnosis was 32.8 years (mean deviation 11.3) and 39.5 years (mean deviation 11.4) respectively. 128 had episodic cluster headache (92.2% males) and 25 chronic cluster headache (76% males). Mean age at the beginning was delayed in chronic cluster headache versus episodic cluster headache (37.6 vs 31.8 years; p= 0.023). Four patients (2.6%) had familial antecedents. 3 (2%) referred to visual aura. At diagnosis, 66% were smokers and 15% heavy alcohol drinkers. Median duration of cluster period and median frequency was 60 days every 2 years. 16 (10.5%) had only one cluster period during follow-up.Conclusion: Theoretical prevalence of cluster headache in our area was 0.05%. The diagnostic delay close to 7 years indicates an insufficient recognition of this entity. A late beginning and being a woman were associated with chronic cluster headache, while one out of ten patients only experienced one cluster period.