Characteristics of patients with cluster headache presenting to a tertiary headache center: A cross-sectional study

Aim Cluster headache (CH) is often underdiagnosed and improperly treated. We explored the characteristics of CH patients referred to our tertiary headache center and compared them to patients with migraine and tension-type headache (TTH). Methods This cross-sectional study was conducted at the Heada...

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Main Authors: Kristin Sophie Lange, Johanna Dorn, Lucas Hendrik Overeem, Mira Pauline Fitzek, Carolin Luisa Hoehne, Ja Bin Hong, Yones Salim, Marlene Ulrich, Uwe Reuter, Bianca Raffaelli
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:Cephalalgia Reports
Online Access:https://doi.org/10.1177/25158163251348665
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author Kristin Sophie Lange
Johanna Dorn
Lucas Hendrik Overeem
Mira Pauline Fitzek
Carolin Luisa Hoehne
Ja Bin Hong
Yones Salim
Marlene Ulrich
Uwe Reuter
Bianca Raffaelli
author_facet Kristin Sophie Lange
Johanna Dorn
Lucas Hendrik Overeem
Mira Pauline Fitzek
Carolin Luisa Hoehne
Ja Bin Hong
Yones Salim
Marlene Ulrich
Uwe Reuter
Bianca Raffaelli
author_sort Kristin Sophie Lange
collection DOAJ
description Aim Cluster headache (CH) is often underdiagnosed and improperly treated. We explored the characteristics of CH patients referred to our tertiary headache center and compared them to patients with migraine and tension-type headache (TTH). Methods This cross-sectional study was conducted at the Headache Center of the Charité – Universitätsmedizin Berlin from December 2015 to January 2023. We collected data on headache characteristics, comorbidities, prior treatments, and treatment recommendations from the doctor's letter generated after their first consultation. Patient-Reported Outcome Measures were assessed using the Headache Impact Test, the Depression, Anxiety and Stress Scale 21, and the Short Form 12. We compared characteristics of patients diagnosed with CH to those with migraine and TTH, matched for age, sex, and body mass index. Results From the overall cohort of 1468 patients (mean age 43 ± 14 years; 75% women), 56 patients (mean age 44 ± 9 years; 23% women) were diagnosed with CH. Among these 56 patients, 54% ( n  = 30) were diagnosed with chronic CH. Although 84% were correctly diagnosed before referral, 34% lacked first-line acute treatment, and 55% had not received guideline-recommended preventive medication. Compared to patients with migraine, patients with CH had a shorter disease duration from onset to referral (5.5 [7.3] years vs. 20.0 [21.0] years, p  < 0.001). Smoking and illicit drug use were significantly more frequent among patients with CH ( p  < 0.001 and p  < 0.05 for the comparison with migraine and TTH, respectively), but not the rate of manifest cardiovascular diseases. Patient-Reported Outcome Measures scores did not differ significantly. Conclusion Both acute and preventive treatment in patients with CH remains inadequate at primary and secondary care levels. The high prevalence of chronic CH suggests a high threshold for referral to specialized centers.
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spelling doaj-art-5da15730f7194a8fa8876b200f4e67692025-08-20T03:30:52ZengSAGE PublishingCephalalgia Reports2515-81632025-06-01810.1177/25158163251348665Characteristics of patients with cluster headache presenting to a tertiary headache center: A cross-sectional studyKristin Sophie Lange0Johanna Dorn1Lucas Hendrik Overeem2Mira Pauline Fitzek3Carolin Luisa Hoehne4Ja Bin Hong5Yones Salim6Marlene Ulrich7Uwe Reuter8Bianca Raffaelli9 Clinician Scientist Program, Berlin Institute of Health (BIH), Berlin, Germany Department of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Berlin, Germany Doctoral Program, International Graduate Program Medical Neurosciences, Humboldt Graduate School, Berlin, Germany Junior Clinician Scientist Program, Berlin Institute of Health (BIH), Berlin, Germany Department of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Berlin, Germany Department of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Berlin, Germany Department of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Berlin, Germany Department of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Berlin, Germany Universitätsmedizin Greifswald, Greifswald, Germany Clinician Scientist Program, Berlin Institute of Health (BIH), Berlin, GermanyAim Cluster headache (CH) is often underdiagnosed and improperly treated. We explored the characteristics of CH patients referred to our tertiary headache center and compared them to patients with migraine and tension-type headache (TTH). Methods This cross-sectional study was conducted at the Headache Center of the Charité – Universitätsmedizin Berlin from December 2015 to January 2023. We collected data on headache characteristics, comorbidities, prior treatments, and treatment recommendations from the doctor's letter generated after their first consultation. Patient-Reported Outcome Measures were assessed using the Headache Impact Test, the Depression, Anxiety and Stress Scale 21, and the Short Form 12. We compared characteristics of patients diagnosed with CH to those with migraine and TTH, matched for age, sex, and body mass index. Results From the overall cohort of 1468 patients (mean age 43 ± 14 years; 75% women), 56 patients (mean age 44 ± 9 years; 23% women) were diagnosed with CH. Among these 56 patients, 54% ( n  = 30) were diagnosed with chronic CH. Although 84% were correctly diagnosed before referral, 34% lacked first-line acute treatment, and 55% had not received guideline-recommended preventive medication. Compared to patients with migraine, patients with CH had a shorter disease duration from onset to referral (5.5 [7.3] years vs. 20.0 [21.0] years, p  < 0.001). Smoking and illicit drug use were significantly more frequent among patients with CH ( p  < 0.001 and p  < 0.05 for the comparison with migraine and TTH, respectively), but not the rate of manifest cardiovascular diseases. Patient-Reported Outcome Measures scores did not differ significantly. Conclusion Both acute and preventive treatment in patients with CH remains inadequate at primary and secondary care levels. The high prevalence of chronic CH suggests a high threshold for referral to specialized centers.https://doi.org/10.1177/25158163251348665
spellingShingle Kristin Sophie Lange
Johanna Dorn
Lucas Hendrik Overeem
Mira Pauline Fitzek
Carolin Luisa Hoehne
Ja Bin Hong
Yones Salim
Marlene Ulrich
Uwe Reuter
Bianca Raffaelli
Characteristics of patients with cluster headache presenting to a tertiary headache center: A cross-sectional study
Cephalalgia Reports
title Characteristics of patients with cluster headache presenting to a tertiary headache center: A cross-sectional study
title_full Characteristics of patients with cluster headache presenting to a tertiary headache center: A cross-sectional study
title_fullStr Characteristics of patients with cluster headache presenting to a tertiary headache center: A cross-sectional study
title_full_unstemmed Characteristics of patients with cluster headache presenting to a tertiary headache center: A cross-sectional study
title_short Characteristics of patients with cluster headache presenting to a tertiary headache center: A cross-sectional study
title_sort characteristics of patients with cluster headache presenting to a tertiary headache center a cross sectional study
url https://doi.org/10.1177/25158163251348665
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