The attacks occur in groups and can last for weeks or months. After this period of attacks, a person may remain cluster free for months or years. Chronic cluster headaches occur for more than one year without remission or with remission lasting less than two weeks. Although not all causes of cluster headaches are known, alcoholic beverages, cold wind or heat blown into the face, certain medications called vasodilators, excitement, and sleep, are known to bring them on. This mechanism of vasodilatation is thought to be the cause of cluster headaches.
Many specialists recommend the person suffering from cluster headaches keep a journal.
By recording when the attacks occur, how long they last and what he or she did in the days before and during the attack, the sufferer may be able to determine what events or factors contributed to the attacks and may be able to avoid these things in the future. Furthermore, he or she may be able to determine what appears to help shorten the length of the attack. Treatment of cluster headaches requires fast-acting medications taken at the very start of an attack. Butopphanol nasal spray is one such medication that has helped cluster headache suffers. Although somewhat inconvenient, this treatment has been extremely helpful for many people and is usually covered by insurance if a letter is sent by the physician.