Those of us who get these headaches are often under considerable stress, but mysteriously, these headaches are not supposed to happen to women. I get a cluster of headaches for two or three days after doing difficult procedures on patients, working extra long hours, or dealing with unpleasant situations at home. I also get cluster headaches during long airplane flights and after being exposed to cigarette smoke. Some of my patients report they get these headaches after arguing with the boss, having a bad day at home, or doing things they don't want to do. One of my colleagues gets a headache every time he administers anesthesia for heart surgery.
Cluster headaches start in a very characteristic way.
Like migraines, these are unilateral headaches. Before a headache starts, patients experience nasal stuffiness on the side that will have the headache. There are often changes in vision in the eye on that side, as well as changes in hearing. As the headache starts, it begins to hurt on one temple, gradually increases in intensity until it becomes very painful. Nausea and vomiting often accompanies it.