Cluster Headaches Versus Migraine Attacks

Severe headaches affect around one in six people in the United States, causing recurring pain, disability, and disruption to daily life. Two of the most severe types are cluster headaches and migraine. While they can both cause intense pain, they have very different patterns, triggers, and treatments.

At Kenneth K. Wogensen, MD, we help patients understand what type of headache they’re dealing with so they can receive the right treatment and relief. Let’s break down the key differences between a migraine attack and a cluster headache.

Migraine

Migraine is a common type of headache disorder, affecting an estimated 1.1 billion people worldwide. The pain is typically severe, and it often throbs or pulses on one side of the head. An attack can last for hours or days, during which time you may experience several or all of the following:

• Nausea and vomiting
• Sensitivity to light and sound
• Blurred vision
• Aura (visual or sensory changes)

Migraine affects far more women than men and often runs in families. Triggers include stress, hormonal changes, certain foods, dehydration, and lack of sleep, but they vary greatly between individuals.

Cluster headache

Cluster headaches are far less common than migraine, affecting around 1% of the population. The headaches come in cycles, meaning they occur frequently over a period of weeks or months, followed by a period of remission during which you experience no headaches.

Cluster headaches usually cause:

• Sudden, intense pain around one eye or on one side of the head
• Watery eyes, drooping eyelids, or nasal congestion on the same side
• Restlessness or agitation
• Attacks at the same time each day

Cluster headaches typically affect men more than women and can occur multiple times a day, sometimes waking patients from sleep. Triggers include alcohol, strong smells, high altitudes, and changes in seasons (especially spring or fall).

We can summarize the differences between a migraine attack and a cluster headache as follows:

Pain type

Migraine pain is throbbing or pulsing; cluster headache pain is sharp, stabbing, or burning.

Pain location

Migraine pain is usually on one side of the head (although it can switch), while cluster headache is always on one side, typically around or behind the eye.

Duration of attacks

A migraine attack lasts between four and 72 hours. A cluster headache lasts between 15 minutes and three hours.

Frequency

Migraine can occur occasionally (sometimes being absent for years) or frequently. Some people have migraine attacks more than fifteen times a month. Cluster headaches occur several times a day during a cycle.

Other symptoms

Common migraine symptoms include nausea, vomiting, sensitivity to light and sound, and aura. Cluster headaches can cause watery eyes, drooping eyelid, nasal congestion, facial sweating, and restlessness.

Typical behavior during an attack

People with a migraine attack typically prefer to lie down in a quiet, dark room. In contrast, those with a cluster headache generally feel restless or agitated and often pace or rock when in pain.

The importance of an accurate headache diagnosis

Many people mistake one type of headache for another. Some think their migraine attack is a sinus headache or confuse a cluster headache for eye strain. You might experience severe headaches due to other causes, such as brain damage or a tumor. That’s why it’s so important to talk to a neurology specialist.

We take the time to ask the right questions, examine patterns, and order imaging to rule out other potential conditions. A correct diagnosis means we can create a personalized treatment plan that works.

Treating migraine and cluster headaches

Migraine treatment focuses on preventing future migraine attacks, reducing migraine symptom severity, and stopping a headache once it starts. Options include:

• Medications like triptans or CGRP monoclonal antibodies
• Anti-nausea drugs
• Blood pressure medications
• Anti-seizure drugs
• Botox® injections

We also provide guidance on improving sleep habits, managing stress, and avoiding triggers.

Because cluster headaches are so intense and sudden, fast-acting treatments are essential. These may include:

High-flow oxygen therapy

Breathing pure oxygen through a mask can stop an attack quickly.

Injectable or nasal medications

Sumatriptan is an effective, fast-acting drug for cluster headaches.

Preventive medications

Verapamil, steroids, and nerve blocks can reduce how often attacks happen.

Some patients with chronic migraine or cluster headaches may benefit from neuromodulation, which involves using devices that help calm pain signals in the brain.

Living with migraine or cluster headaches

If you’re living with frequent or severe headaches, you don’t have to suffer in silence. The first step is to understand the type of headache you’re experiencing.

We specialize in diagnosing and treating all types of headaches with care, compassion, and evidence-based medicine. Whether it’s migraine attacks, cluster headaches, or something else entirely, we’re here to help you find lasting relief and take back control of your life.

Contact Kenneth K. Wogensen, MD, today to schedule an evaluation. Call the office, or complete the inquiry form on our website.