A severe headache with watering eye and a runny or blocked nose may not always be caused by sinusitis. In some cases, those symptoms may indicate a cluster headache, a neurological condition that causes intense pain, usually around or behind one eye.
According to a report by Hindustan Times on October 12, neurosurgeon Dr Jaydev Panchawagh, senior consultant neurosurgeon at Sahyadri Super Speciality Hospital, explained why cluster headaches are sometimes mistaken for sinusitis. Patients who get these symptoms can receive treatment for sinus problems without lasting relief.
It’s a distinction because sinusitis and cluster headaches have different causes and need different treatments. The signs and symptoms of pain, the duration and the symptoms for which it comes in can help diagnose it, the doctors can do.
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What is Cluster Headache?
Cluster headache is a type of primary headache disorder with severe pain on one side of the head. Pain usually develops around or behind one eye or near the temple. Attacks can happen very quickly and may be severe enough to disrupt our daily lives.
The pain can feel piercing or burning, as Dr Panchawagh said. Unlike an ordinary headache that gradually improves, a cluster headache can lead to repeated episodes of severe pain. An attack typically lasts between 15 minutes and three hours, he said.
The attacks may occur multiple times a day, sometimes at the same time of day or at night. Some people might have these attacks for weeks or months and then go through one time or so before they move on and not get headaches.
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Other symptoms may include:
- Watering and redness of the eye: The eye on the affected side may become red and produce excessive tears.
- Nasal congestion: The nostril on the same side as the headache may become blocked or runny.
- Eyelid changes: The eyelid may be swollen or droop during an attack.
- Restlessness: People are also not able to remain still and can pace or turn around because of the pain.
These symptoms can certainly be helpful in medical evaluation, of course. But a watering eye or a blocked nose alone cannot tell if someone has a cluster headache. Doctors look at the full symptom pattern and may consider other causes. Source: Cleveland Clinic
Sinusitis vs Cluster Headache: How Are They Different?
Sinusitis occurs when the tissues lining the sinuses become inflamed, often after an infection happens. Facial pain, pressure and nasal congestion are common. You may also feel a lack of smell or nasal discharge and fever.
Cluster headaches are neurological headache attacks. Although they can produce nasal symptoms and pain around the eyes, their timing and intensity are often different than sinusitis.
A sinus headache causes pressure or a dull ache around the forehead, cheeks, nose, or behind the eyes. Cluster headaches can lead to acute, one-sided pain around or behind one eye. Pain can take place in different attacks and reoccur at different times.
The nature of nasal discharge might be another clue. Cluster headaches can cause clear, watery discharge from one nostril during an attack. Sinusitis may also cause a thicker nasal discharge, depending on the underlying cause.
Another difference is the overall pattern of symptoms. Nasal congestion and facial pressure associated with sinusitis may persist beyond individual episodes of pain. Cluster headache symptoms tend to occur during defined attacks, often alongside watering or redness of the eye on the painful side.
The two conditions can be confused because they share some symptoms. But they are not enough to diagnose them without a medical check. Hindustan Times, Cleveland Clinic.
Cluster Headache treatment and when to seek medical help
Cluster headaches are treated differently from sinusitis. Antibiotics and decongestants do not treat cluster headaches because it is neurological rather than a sinus infection, Panchawagh said.
Doctors can also use high-flow oxygen or triptans for an acute cluster headache attack. Preventive medicines may be prescribed to minimize the number and severity of attacks during a cluster period. Those patients who don’t respond well to standard treatment may require specialist care or other therapies.
The treatments must be carried out under medical supervision. The patient's symptoms, medical history and the circumstances of the patient must be considered to the best of our knowledge.
Keeping a headache diary also helps diagnosis. Recording when an attack starts, how long it lasts, where the pain occurs and whether eye or nasal symptoms are present as well as why a doctor may identify recurring patterns can be helpful.
People should seek emergency medical care if they receive a sudden, extremely severe headache, particularly if it is new or unusual. Headache with weakness, difficulty speaking, fainting, seizures or loss of vision also needs urgent assessment.
A headache with a watering eye shouldn’t be attributed to sinusitis. The difference between sinus-related symptoms and cluster headache attacks can help patients to get a good evaluation and avoid treatment delays.
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