It is vascular in nature, and the pain is caused by blood vessel swelling in the head. Although rare, it is possible for someone with cluster headache to also suffer from migraine headache. Cluster headache starts suddenly, and a minimal type of warning of the oncoming headache may occur, including a feeling of discomfort or a mild one-sided burning sensation. The pain is of short duration, generally 30 to 45 minutes. However, the headache may last anywhere from a few minutes to several hours and will disappear only to recur later that day.
Most sufferers get one to four headaches per day during a cluster period.
They occur regularly, generally at the same time each day. The pain of cluster headache is generally intense and severe and often described as a burning or piercing sensation. It may be throbbing or constant, the scalp may be tender and the arteries often can be felt increasing their pulsation. The pain is so intense that most sufferers cannot sit still and will often pace during an acute attack. Cluster headaches generally reach their full force within five or ten minutes after onset.