Cluster Headaches

A 50 year old white male complains of a headache on one side of his head for decades. 

Before I Translate The Article

Cluster headaches are a form of a vascular headache.  Cluster headaches are also known as histaminic cephalagia, histaminic headaches, Horton's cepahalgia, Horton's syndrome, or migrainous neuralgia.  But whatever the name, the result is the same a chronic recurring headache that can difficult to treat.

The exact cause of clusters headaches if not fully know but several theories have been put forth that include vasomotor, hypothalamic, or neurohormonal causes.  The vascular theory suggests that during an attack the blood vessels dilate, which creates pressure on the trigeminal nerve.  The trigeminal nerve (TGN) is the main nerve of the face that is responsible for the sensations of cold and pain.  When the TGN is activated, it is what causes the pain around the eyes.  Substance P neurons carry sensory and motor impulses in the maxillary and
ophthalmic divisions of the trigeminal nerve.