Aura in Cluster Headache: A Cross-Sectional Study

Ilse F. de Coo, MD; Leopoldine A. Wilbrink, MD; Gaby D. Ie, MD; Joost Haan, MD, PhD; Michel D. Ferrari, MD, PhD


Headache. 2018;58(8):1203-1210. 

In This Article


Cluster headache is a rare headache disorder typically characterized by attacks of excruciating, unilateral temporal or (peri-)orbital pain lasting 15–180 minutes and associated with facial autonomic symptoms and/or restlessness.[1] Migraine-like aura symptoms have been reported in up to 23% of cluster headache patients.[2–5] For many clinicians, this seems much higher than to their clinical impression. The auras reported are most often visual and sometimes very short-lasting. Diagnostic criteria differ between migraine and cluster headache in the International Classification of Headache Disorders-III (ICHD-III beta).[1] In migraine with and without aura are the major subtypes.[1] Aura is not mentioned in the cluster headache criteria. Therefore, for a patient with cluster headache and typical aura, the criteria formulated for "typical aura with headache" seem closest.[1]

In migraine, attacks with aura are in general associated with a shorter and less severe headache phase.[6] This has led to the hypothesis that different mechanisms are involved in migraine with and without aura.[6–9] Here, we set out to investigate whether attacks of cluster headache with and without aura differ with respect to the other clinical characteristics.