Incidence of cluster-like post-traumatic headache: An inconsistency

Objective: To examine the incidence of clusterlike post-traumatic headache reported by some of our colleagues, to report our findings, and to review the literature related to post-traumatic cluster headache. Data Sources: This review was based on relevant English-language articles published from 1982 to the present and references from identified articles. Study Selection: Particular attention was given to four articles discussing the incidence and mechanisms of cluster-like posttraumatic headache. Also, a few salient articles describing types of posttraumatic headache similar to cluster (ie cervicogenic headache) and some describing idiopathic cluster headache were examined. Data Synthesis: Cluster-like symptoms have been reported by several authors to occur in 6 to 10 percent of post-traumatic headache cases. In a review of 200 consecutive post-traumatic headache patients seen at our headache clinic, however, we have found no instances of a cluster pattern. Conclusion: Proposed reasons for this discrepency are a difference in post-traumatic headache population samples or differences in the way diagnostic criteria are applied. Some cases may be ''cluster-like'' post-traumatic headaches, or represent referred pain or cervicogenic headache. Post-traumatic cluster headache may not be as frequent as previously described.