Cluster Headache, Tension-Type & the TACs: PH, SUNCT, Hemicrania Continua | Headache Part 4

Tension-type headache is the commonest headache, yet the disabling "tension headache" in your clinic is usually migraine. The trigeminal autonomic cephalalgias are rare, distinct and highly treatable. This video covers both at registrar and consultant level, with doses, trial data and the indomethacin trial. In this video: • TTH: epidemiology, mechanism, ICHD-3 and the diagnostic trap • TTH acute treatment and prevention (BAMV) • TACs by attack length: SUNCT seconds, PH minutes, cluster hours, HC always • Trigeminal-autonomic reflex and the hypothalamic clock • Cluster: who gets it, the attack, criteria, secondary causes • Oxygen and SC sumatriptan; verapamil with ECG monitoring and steroid bridge • Galcanezumab, lithium, nerve blocks and neurostimulation • Paroxysmal hemicrania and the indomethacin trial • SUNCT/SUNA: lidocaine, lamotrigine and MVD • Hemicrania continua; the four TACs side by side Chapters: 0:00 Tension-type headache 0:55 From muscle to brain 1:54 Diagnosis: everything migraine isn't 3:03 The diagnostic trap 4:11 TTH: acute treatment 5:42 TTH: prevention 7:24 The trigeminal autonomic cephalalgias 8:12 Reflex and oscillator 9:27 Cluster headache: who gets it 10:19 The cluster attack 11:19 Cluster: diagnosis 12:28 Cluster: aborting the attack 13:42 Cluster: preventing the bout 14:46 Cluster: second line and beyond 15:54 Paroxysmal hemicrania 17:00 The indomethacin trial 18:26 SUNCT and SUNA 19:35 SUNCT and SUNA: treatment 20:43 Hemicrania continua 22:06 The TACs side by side 22:51 Recap Headache Series (7 parts): • Part 1 — Approach & Red Flags: [add link] • Part 2 — Migraine, Variants & Stroke: [add link] • Part 3 — Migraine Treatment: [add link] ▶ Part 4 — Tension-Type Headache & the TACs (this video) • Part 5 — Rare Primaries, Thunderclap, RCVS & MOH: [add link] • Part 6 — CSF Pressure & Secondary Headaches: [add link] • Part 7 — Cranial Neuralgias & Facial Pain: [add link] Key references: • Headache Classification Committee of the IHS. ICHD-3. Cephalalgia 2018;38:1–211 • UpToDate topic reviews on headache disorders (2024–2026 updates) • Bendtsen L et al. EFNS guideline on the treatment of tension-type headache. Eur J Neurol 2010 • May A et al. Cluster headache. Nat Rev Dis Primers 2018 • Cohen AS et al. High-flow oxygen for treatment of cluster headache: a randomized trial. JAMA 2009 • Goadsby PJ et al. Trial of galcanezumab in prevention of episodic cluster headache. N Engl J Med 2019 This video is for education only and is not medical advice. Follow your local protocols and check every dose against your formulary. #ClusterHeadache #Neurology #medicaleducationindia