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Cluster Headache Diagnosis & The Various Tests Involved

Man explaining to the doctor his head pain

Having a cluster headache attack is among the worst types of pain that anyone can experience. But since this condition is so different from other types of headaches, obtaining an accurate diagnosis of cluster headaches is very important.

Cluster headaches occur in patterns, so it is essential to understand the location and severity of the pain and to assess the other symptoms that are typically present along with it. Physicians use various approaches to pinpoint cluster headache attack pain and the triggers that cause it.

Here is some information about what’s involved in a cluster headache diagnosis and the types of tests that may be involved to make this determination.

Do I Have Cluster Headaches?

Cluster headaches are more common in men than women and usually begin around the age of 30. The answer to “Do I have cluster headaches?” may be yes if the headaches occur in groups and last one to three hours per attack. They are also commonly triggered by alcohol, cigarettes, altitude changes, heat, foods with nitrates, and exercise.

However, it is crucial to consult an experienced physician about suspected cluster headache attack symptoms to determine if a cluster headache diagnosis is actually correct. The first step in making a diagnosis is to review the pattern of recurrent headaches over a period of time.

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CT Scan or MRI

Imaging tests, such as CT scans and MRIs, are commonly used to help doctors make a cluster headache diagnosis. A CT scan uses multiple X-rays to view a cross-section of the brain. Meanwhile, an MRI uses radio waves and a magnetic field to create comprehensive images of the blood vessels and brain. The brain CT scan or MRI will produce a normal result for a primary cluster headache. Results may be abnormal if there are secondary causes, such as a tumor.

Blood Tests

In addition to imaging tests, blood tests may also be taken to determine is another condition is causing the cluster headache attacks. For example, a blood test may show evidence of hypothyroidism or inflammation in the blood vessels of the head that could be causing headache pain.

Erythrocyte Sedimentation Rate (ESR)

The purpose of a ESR test is to show where inflammatory activity is present in the body. It is used to rule out certain infections, autoimmune diseases, and cancers that could be causing the head pain. A person with a primary cluster headache diagnosis will typically yield a normal ESR test result.

Pituitary Function Tests

This is another possible diagnostic test for doctors to order when a cluster headache condition is suspected. It will rule out secondary causes that result from a pituitary adenoma.


Since cluster headaches are closely associated with sleep, a doctor may also order a polysomnogram, which is a sleep study. This test is used to diagnose sleep disorders, and it does so by recording brain waves, blood oxygen levels, breathing rates, heart rate, and involuntary leg and eye movements. Individuals who have sleep apnea will produce an abnormal result for this test.

Electroencephalogram (EEG)

In rarer cases, an EEG may be used to make a diagnosis about an individual’s headache condition. This is most common among people who have seizures as well as severe headaches.

Spinal Tap

A cluster headache diagnosis rarely requires a spinal tap, but it is possible if there is a serious concern about one’s diagnosis. A spinal tap can rule out a diagnosis of meningitis, which is a serious condition that can also cause headaches due to infection around the spinal cord and brain.

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