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chronic cluster headache

Causes of Daily Headaches

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Some daily headaches start all of a sudden. Others are just headaches that gradually become more frequent. The causes of daily headaches are sometimes obvious, and other times completely unknown.

causes of daily headachesAlthough some people are diagnosed with chronic daily headaches, the term is very general and could refer to a variety of conditions. If you haven’t received a specific diagnosis, talk to a specialist.

Now, let’s look at some examples of causes of daily headaches:

Various Secondary Headaches

There are a whole range of secondary headaches that can be a daily problem – too many to list here. But think of pain from a tumour, a recent trauma to the head or neck, aneurysm, and cervicogenic headache.

Causes: Too numerous to mention.

Many of these headaches are serious enough that you should get to a doctor right away. But how can you tell?

If you have headaches that are getting worse day by day, or if you’re experiencing changes in headache symptoms, or if you’re getting headaches after an event you can remember (such as an accident or illness), see your doctor right away. She can help you narrow things down, and get you the treatment you need.

Chronic Migraine

Most daily headaches are actually a form of chronic migraine. So why does migraine become chronic?

Causes: Genetics may be the #1 reason. Other reasons include poor treatment (using the wrong medications, or too many over the counter medications, for example), depression, obesity, or sleep disorders.

Often the cause is unknown, but migraine symptoms could also be the result of an underlying disease, or a recent physical trauma. Again, when symptoms change, see a doctor as soon as possible.

Chronic Tension-Type Headache

Some daily headaches may actually be a combination of migraine and tension-type headache.

Causes: Tension-type headaches may become chronic for similar reasons that migraine becomes chronic. But the reason often remains unknown.

In spite of its name, we now know that tension-type headaches are not simply caused by tension. The actual cause may lie deep in the brain.

New Daily-Persistent Headache (NDPH)

With NDPH, patients know the exact day when the headache began. This is not a gradual-onset type of headache.

Causes: Usually the cause is unknown. However, patients often report that the headaches started with a flu-like illness. Sometimes the start of the headache is corrolated with a stressful life event, or a surgery. Read more here: What Triggers New Daily Persistent Headache?

Hemicrania Continua

Hemicrania continua is a rare one-sided headache that is usually treated with indomethacin. Hemicrania continua is often misdiagnosed.

Causes: Unknown

Chronic Cluster Headache

Like migraine and tension-type headache, cluster headache can become chronic.

Causes: Largely unknown. Factors may be similar to migraine, when it comes to why cluster becomes chronic.

Conclusion

There are other types of daily headache, but that covers the majority. In most cases, it probably won’t be immediately obvious why you start getting daily headaches.

Causes of daily headaches, if known, can be a big step toward proper treatment. If you do have some idea why your headaches have gotten worse or why they started, talk to your doctor.

Although daily headaches can increase at the same time as stress in your life, the stress is probably not the cause. It’s easy to think that the headaches are “normal” when you’re going through stress, and that they’ll get “better” when the stress goes away.

However, this can keep you from investigating what the real cause is. So be very careful before you blame daily headaches on “stress”. Lots of people under hugely stressful events are headache-free.

Deep Brain Stimulation is helping Chronic Cluster Patients

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Deep Brain Stimulation (DBS) is a treatment that is showing great promise when it comes to treating cluster.  Unfortunately, many people know very little about it.

Deep Brain Stimulation for Cluster Headache

DBS is probably most well known as a treatment for Parkinson’s disease, though it’s used for a variety of conditions, including cluster headache.

Though much of the mechanism of cluster remains a mystery, we do know that the posterior hypothalamus is involved.  The posterior hypothalamus is part of the hypothalamus part of your brain, located just above the brain stem.  Like migraine, there is likely a complex web of reactions going on that impact cluster.  However, the posterior hypothalamus seems to be a key part of the process.

So what would happen if we could stimulate this part of the brain directly?

DBS uses a battery operated device known as a neurostimulator.  This small device is surgically implanted.  It’s then able to target the posterior hypothalamus and deliver electric stimulation.

The neurostimulator itself is not in contact with the target area.  Instead, a lead/electrode wire is placed in the target area.  Then an extension connects the lead to the neurostimulator itself.  Multiple leads may be implanted in target areas.

Once the system is in place, it can be adjusted without further surgery.

Who is this treatment for?  The best candidate for deep brain stimulation is someone with chronic cluster headache.  In fact, it’s been suggested that even stricter criteria be used: patients who are the best candidates are ones who have attacks almost every day.  Also, these patients are usually not helped by the standard drug treatments.

Recently, researchers have started investigating the uses of DBS in other parts of the brain, such as the midbrain tegmentum.  We may find that some patients respond better to stimulation in one area, and others improve with stimulation in another area.

The good and the bad of deep brain stimulation for cluster…

The good news is that the surgery is generally safe.  However, that does come with a word of caution.  It’s important to have an expert team perform the surgery – if possible, someone with experience with DBS for cluster, since there are unique challenges for cluster patients.  The patient needs to be monitored to avoid problems such as bleeding and infection and issues with wire placement.  Usually these are not major problems, and treatment can be continued.  But you do need an expert who knows how to deal with them.

It’s also important to realize that improvement is not immediate.  Usually several weeks of stimulation are required before there is a real change.

The other challenge with DBS is that it’s still relatively new.  Yes, we have about 10 years of experience using it for cluster.  But chronic cluster is so rare that we’re still only talking about a few dozen patients.  More studies need to be done to understand how best to use DBS.

DBS seems to help about 60% of chronic cluster patients.  The good news is that those 60% end up almost pain-free.  And this is without drugs, which means a lower overall cost as well.

For more details on the use of DBS for cluster, read:  Deep brain stimulation in trigeminal autonomic cephalalgias. (2010 overview)  and DEEP BRAIN STIMULATION TREATMENT FOR CLUSTER HEADACHE (more in-depth overview from 2005).

Also check out Cluster or Migraine: What’s the Difference?

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The articles on Headache and Migraine News are © 2004-2026 J. Cottrill.
Every effort is made to ensure the accuracy of each article, and to point you to further sources of information. However, this site is for informational purposes only and should never replace a visit to your doctor.