Diagnosing cluster headache

Cluster headache can be associated with structural lesions in the pituitary gland or surrounding regions, so requesting an MRI with pituitary views is advisable. Cluster headache is known as a 'suicide headache’ because the pain is so severe. Urgently refer a patient with suspected cluster headache for expert review, to confirm the diagnosis and optimise treatment—if the patient is having an acute attack, send them to an emergency department. Cluster headache can be treated acutely and preventively. Bridging strategies may be needed to control the headaches while starting a preventive drug.