Cluster headaches and oxygen

Brandon O

Brandon O

Puzzled by facies
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No experience, but it sounds like a pretty cool idea. I get cluster headaches/migraines every so often (thankfully, not very often!) and that sounds like an awesome way to help make them go away! I'd be interested in follow-up studies.
 
My partner gets them and he has used O2 in the past to aid in relieving them.
 
I have heard anecdotal reports of oxygen working for cluster migraines if used immediately at onset, but I haven't seen much hard data to support it.
 
Let's try and maintain the distinction between migraines and true cluster headaches, which (in my slim understanding) are a distinct entity.

Cluster headaches are far more rare and cause some of the most severe pain known to medicine. They are considered a risk factor for suicide.
 
I've used oxygen in the past on headaches that I had thought might be cluster. But even with years in EMS/EM, I'm no neurologist.

Now I just hit them all with metoclopramide, go from there.
 
KellyBracket said:
I've used oxygen in the past on headaches that I had thought might be cluster. But even with years in EMS/EM, I'm no neurologist.
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So as a non-neurology, knuckle-dragging emergentologist, did it seem to help? ;)
 
As my mentor Doctor Cottle would say, I have no frakking clue.

The dopamine antagonists seem to work via some common pathway nonsense, so I don't have worry about etiological finery. 10 mg * 2 seems to take care of 90+% of HA.
 
How does high flow O2 help relieve pain of cluster headaches? That is to say, why is it better than placebo?
 
Cluster headaches are not new and they aren't all DEFCON 4. Used to successfully treat many of them with chlortrimeton or benadryl. P.O. Trick is to recognize the symptoms and complaints. EDIT: and begin treating early.

We used to give VIstaril and Demerol IM for "migraine headaches"; it's not unlikely the Vistaril was swatting down the cluster headaches (and addressing Demerol's side effects), and the Demerol (when it didn't make people hallucinate or vomit) covered the rest and made patients not care so much about having a headache.
 
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EpiEMS said:
How does high flow O2 help relieve pain of cluster headaches? That is to say, why is it better than placebo?
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From what I can glean, the prevailing theory behind cluster headaches seems to be that they involve inappropriate vasodilation which creates mechanical pressure upon the trigeminal nerve. The oxygen is thought to cause vasoconstriction.
 
Brandon O said:
From what I can glean, the prevailing theory behind cluster headaches seems to be that they involve inappropriate vasodilation which creates mechanical pressure upon the trigeminal nerve. The oxygen is thought to cause vasoconstriction.
Click to expand...

That is how I understand it. Same reason the Imitrex helps.
 
Brandon O said:
Let's try and maintain the distinction between migraines and true cluster headaches, which (in my slim understanding) are a distinct entity.

Cluster headaches are far more rare and cause some of the most severe pain known to medicine. They are considered a risk factor for suicide.
Click to expand...
all that sounds consistent with my grandfather's diagnosis of cluster headaches.

Anonymous said:
That is how I understand it. Same reason the Imitrex helps.
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i've experienced Imitrex relieving migranes as well.

i'm only in school at the moment, but it seems to me like we use oxygen in almost all situations with a thought that "why not, it shouldn't hurt". i don't know how common this is in reality, obviously.
 
Brandon O said:
From what I can glean, the prevailing theory behind cluster headaches seems to be that they involve inappropriate vasodilation which creates mechanical pressure upon the trigeminal nerve. The oxygen is thought to cause vasoconstriction.
Click to expand...

Ok, makes sense -- same sort of reasoning behind including caffeine in the AAC tablets. Thanks for a great explanation, makes a lot more sense now!
 
Brandon O said:
From what I can glean, the prevailing theory behind cluster headaches seems to be that they involve inappropriate vasodilation which creates mechanical pressure upon the trigeminal nerve. The oxygen is thought to cause vasoconstriction.
Click to expand...

PA and MD students:

Quick! without looking it up, name as many branches of the trigeminal nerve as you can.

No, not V1, V2, and V3.....all the branches....

I can't remember this stuff to save my life. If anyone knows of any good memory tricks, please let me know.
 
Halothane said:
PA and MD students:

Quick! without looking it up, name as many branches of the trigeminal nerve as you can.

No, not V1, V2, and V3.....all the branches....

I can't remember this stuff to save my life. If anyone knows of any good memory tricks, please let me know.
Click to expand...

Copy and paste make quotes like that easier.
 
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