It’s well known that oxygen will feed a fire; it’s less well known that oxygen can curtail an attack of cluster headache. Once nicknamed “suicide headache” because of its severity, cluster headache is characteristically experienced as recurrent attacks of unilateral excruciating pain usually in the eye, periorbital region and temple, with associated cranial autonomic symptoms.1,2 Untreated attacks typically last for 15 to 180 minutes. A randomised, double-blind, placebo-controlled crossover study in 109 patients with cluster headache in the UK has confirmed that, compared with placebo, treatment with inhaled high-flow oxygen at symptom onset is more likely to result in patients being pain-free within 15 minutes.2 The more usual treatment for cluster headache is a triptan, administered by injection. The researchers said that a head-to-head comparison between a triptan and oxygen is both warranted and feasible.
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