After migraine, the most common type of vascular headache is
the toxic headache produced by fever. Pneumonia, measles, mumps,
and tonsillitis are among the diseases that can cause severe toxic
vascular headaches. Toxic headaches can also result from the
presence of foreign chemicals in the body. Other kinds of vascular
headaches include "clusters," which cause repeated episodes of
intense pain, and headaches resulting from a rise in blood
.Repeated exposure to nitrite
compounds can result in a dull, pounding headache that may be
accompanied by a flushed face. Nitrite, which dilates blood
vessels, is found in such products as heart medicine and dynamite,
but is also used as a chemical to preserve meat. Hot dogs and other
processed meats containing sodium nitrite can cause headaches.
Eating foods prepared with monosodium glutamate (MSG) can result
in headache. Soy sauce, meat tenderizer, and a variety of packaged
foods contain this chemical which is touted as a flavor
Headache can also result from exposure to poisons, even common
household varieties like insecticides, carbon tetrachloride, and
lead. Children who injest flakes of lead paint may develop
headaches. So may anyone who has contact with lead batteries or
Artists and industrial workers may experience headaches after
exposure to materials that contain chemical solvents. Solvents,
like benzene, are found in turpentine, spray adhesives, rubber
cement, and inks.
Drugs such as amphetamines can cause headaches as a side effect.
Another type of drug-related headache occurs during withdrawal from
long-term therapy with the antimigraine drug ergotamine
Jokes are often made about alcohol hangovers but the headache
associated with "the morning after" is no laughing matter.
Fortunately, there are several suggested remedies for the pain,
including ergotamine tartrate. The hangover headache may also be
reduced by taking honey, which speeds alcohol metabolism, or
caffeine, a constrictor of dilated arteries. Caffeine, however, can
cause headaches as well as cure them. Heavy coffee drinkers often
get headaches when they try to break the caffeine habit.
.Cluster headaches, named for
their repeated occurrence in groups or clusters, begin as a minor
pain around one eye, eventually spreading to that side of the face.
The pain quickly intensifies, compelling the victim to pace the
floor or rock in a chair. "You can't lie down, you're fidgety,"
explains a cluster patient. "The pain is unbearable." Other
symptoms include a stuffed and runny nose and a droopy eyelid over
a red and tearing eye.
Cluster headaches last between 30 and 45 minutes. But the relief
people feel at the end of an attack is usually mixed with dread as
they await a recurrence. Clusters can strike several times a day or
night for several weeks or months. Then, mysteriously, they may
disappear for months or years. Many people have cluster bouts
during the spring and fall. At their worst, chronic cluster
headaches can last continuously for years.
Cluster attacks can strike at any age but usually start between
the ages of 20 and 40. Unlike migraine, cluster headaches are more
common in men and do not run in families. Research scientists have
observed certain physical similarities among people who experience
cluster headache. The typical cluster patient is a tall, muscular
man with a ragged facial appearance and a square, jutting or
dimpled chin. The texture of his coarse skin resembles an orange
peel. Women who get clusters may also have this type of skin.
Studies of cluster patients show that they are likely to have
hazel eyes and that they tend to be heavy smokers and drinkers.
Paradoxically, both nicotine, which constricts arteries, and
alcohol, which dilates them, trigger cluster headaches. The exact
connection between these substances and cluster attacks is not
Despite a cluster headache's distinguishing characteristics, its
relative infrequency and similarity to such disorders as sinusitis
can lead to misdiagnosis. Some cluster patients have had tooth
extractions, sinus surgery, or psychiatric treatment in futile
efforts to cure their pain.
Research studies have turned up several clues as to the cause of
cluster headache, but no answers. One clue is found in the
thermograms of untreated cluster patients, which show a "cold spot"
of reduced blood flow above the eye.
The sudden start and brief duration of cluster headaches can
make them difficult to treat; however, research scientists have
identified several effective drugs for these headaches. The
antimigraine drug ergotamine tartrate can subdue a cluster, if
taken at the first sign of an attack. Injections of
dihydroergotamine, a form of ergotamine tartrate, are sometimes
used to treat clusters.
Some cluster patients can prevent attacks by taking propranolol
or methysergide. Investigators have also discovered that mild
solutions of cocaine hydrochloride applied inside the nose can
quickly stop cluster headaches in most patients. This treatment may
work because it both blocks pain impulses and constricts blood
Another option that works for some cluster patients is rapid
inhalation of pure oxygen through a mask for 5 to 15 minutes. The
oxygen seems to ease the pain of cluster headache by reducing blood
flow to the brain.
In chronic cases of cluster headache, certain facial nerves may
be surgically cut or destroyed to provide relief. These procedures
have had limited success. Some cluster patients have had facial
nerves cut only to have them regenerate years later.
.Chronic high blood pressure can
cause headache, as can rapid rises in blood pressure like those
experienced during anger, vigorous exercise, or sexual
The severe "orgasmic headache" occurs right before orgasm and is
believed to be a vascular headache. Since sudden rupture of a
cerebral blood vessel can occur, this type of headache should be
evaluated by a doctor.