Cluster headaches are also known as migrainous neuralgia, histamine headache, rock neuralgia, pterygopalatine neuralgia, and Horton headache. Patients have a series of severe headaches that occur suddenly over a period of time, usually without an aura. The pain is mostly found in one orbital or (and) frontotemporal region, and may be accompanied by ipsilateral conjunctival congestion, tearing, eyelid edema or nasal congestion, runny nose, and sometimes narrow pupils, droopy lids, flushing, and swollen cheeks. The headache is characterized by a series of headache attacks that appear to come in clusters. The attacks are periodic and have no antecedent symptoms. The pain starts around the eye sockets on one side and extends rapidly to the frontal-temporal region, and in severe cases may involve the opposite side. The pain is pulsating, with drilling or burning pain, and can be awakened during sleep. The headache is mostly non-pulsating and severe, with the patient fidgeting or shaking from front to back, and some patients punching their heads to relieve the pain. Many patients have headaches at a fixed time, often in the late afternoon or early morning. Drinking alcohol or nitroglycerin can trigger a headache attack. The headache is often confined to the same side. Each attack lasts 15 to 180 minutes and will resolve on its own. Sequences of attacks last from 2 weeks to 3 months (called clusters), and many patients have clusters that occur in the same season of the year. Intermittent periods last from several months to several years, during which symptoms resolve completely. Approximately 10% of patients have chronic symptoms. Characteristic concomitant symptoms include flushing of the face, sweating, tearing on the affected side, conjunctival congestion, and nasal congestion. In addition to superficial temporal artery anger, there is also incomplete Horner’s syndrome such as narrowing of the affected pupil and drooping eyelids. The disease is most common in young people (20-40 years old), 4-7 times more common in men than in women, and there is usually no family history. Treatment of cluster headache 1. Analgesic tranquilizers are not effective during headache attacks. Physical factor therapy, acupuncture therapy as adjunctive treatment, can be used with medication to control symptoms. 2.Prevention of nocturnal attacks: rectal suppository of ergotamine or subcutaneous injection of dihydroergotamine before bedtime. If necessary, stellate ganglion block can be used to relieve pain attacks, and pterygopalatine ganglion block can also be considered.