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Chronic cluster headaches

Chronic cluster headaches and migraine

Migraine headache is defined as: severe periodic, unilateral, pulsatile headache associated with nausea, sickness, vomiting and photophobia.

Factors that often precipitate attack are environmental triggers such as emotional stress, strenuous physical exercise, too much sleep or sleep deprivation, some foods (chocolate, aged cheese, nuts), alcohol (red wine), medical conditions and medications (anti-hypertensive drugs, contraceptive, nitroglycerin).

In the pathogenesis of migraine headaches, vascular and biochemical changes play important roles. The first phase is vasospasm accompanied by reduction in blood flow causing ischemia and edema of intracranial vessels, followed by the second phase of vasodilatation (extra-cranial vessels) with hyperemia (an increased amount of blood in a part or organ) and platelet aggregation that impairs microcirculation leading to pain.

Undersea and Hyperbaric Medical Society Committee does not include migraine headaches on the list of approved indications for the insurance reimbursements. However, published reports that have found the relief of migraine and cluster headache with hyperbaric oxygen (HBO) are claiming the vasoconstrictive effect of hyperbaric oxygen is more effective and naturally healthier than vasoconstrictive drugs.

Benefits of hyperbaric oxygen therapy in Migraine and other chronic headaches:

  • Relieves pain by improved oxygenation of the brain
  • Improves blood flow and microcirculation in the brain
  • Reduces swelling of the brain caused by inflammatory response
  • Decreases platelet aggregation (possibility of blood clotting)
  • Reduces chances of further headache attacks
  • Boosts energy

Best results with hyperbaric oxygen is obtained when person is treated while having a migraine attack which is usually hard to achieve. As reported by Fife and Fife in 1989 who treated 26 patients with migraine headaches by hyperbaric oxygen with pressures up to 2.4 atm the pain was relieved within minutes of exposure. Cluster headaches also respond to normobaric (breathing pure oxygen at normal pressure) and  hyperbaric oxygen. Mechanisms and published references to those who are interested to read more are listed below.

Further reading:

  1. Lin et al. Treatment with normobaric or hyperbaric oxygen and its effect on neuropsychometric dysfunction after carbon monoxide poisoning - A systematic review and meta-analysis of randomized controlled trials, Medicine (2018) 97:39(e12456)
  2. Fife WP, Fife CE. Treatment of migraine with hyperbaric oxygen. J. Hyperb. Med. 4, 7–15 (1989).
  3. Wilson JR, Foresman BH, Gamber RG, Wright T. Hyperbaric oxygen in the treatment of migraine with aura. Headache. 1998 Feb;38(2):112-5.
  4. Stovner LJ, Sjaastad O. Treatment of cluster headache and its variants. Curr Opin Neurol. 1995 Jun;8(3):243-7.
  5. Myers DE1, Myers RA. A preliminary report on hyperbaric oxygen in the relief of migraine headache. Headache. 1995 Apr;35(4):197-9.
  6. Nilsson Remahl AI1, Ansjön R, Lind F, Waldenlind E. Hyperbaric oxygen treatment of active cluster headache: a double-blind placebo-controlled cross-over study. Cephalalgia. 2002 Nov;22(9):730-9.
  7. Bennett MH1, French C, Schnabel A, Wasiak J, Kranke P, Weibel S. Normobaric and hyperbaric oxygen therapy for the treatment and prevention of migraine and cluster headache. Cochrane Database Syst Rev. 2015 Dec 28;(12):CD005219. doi: 10.1002/14651858.CD005219.pub3
  8. Kiralp MZ, Yildiz S, Vural D, Keskin I, Ay H, Dursun H. Effectiveness of hyperbaric oxygen therapy in the treatment of complex regional pain syndrome; J Int Med Res. 2004 May-Jun;32(3):258-62.
  9. Di Sabato F, Fusco BM, Pelaia P, Giacovazzo M., Hyperbaric oxygen therapy in cluster headache. Pain. 1993 Feb;52(2):243-5
  10. Di Sabato F, Giacovazzo M, Cristalli G, Rocco M, Fusco BM. Effect of hyperbaric oxygen on the immunoreactivity to substance P in the nasal mucosa of cluster headache patients. Headache. 1996 Apr;36(4):221-3.

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 Information contained on this site is intended for general consumer understanding and education. It should not be used as a substitute for any medical professional opinion, advice or prescribed medication nor should it serve as diagnosis or treatment of health problems.