June is Migraine and Headache Awareness Month, which makes this a good time to learn more about one of the most painful types of headache: the cluster headache.

Cluster headaches occur in cyclical patterns or cluster periods that can last from weeks to months. During a cluster period, headaches usually occur daily, sometimes several times a day. A single attack can last from 15 minutes to three hours. The attacks often occur at the same time each day, most often at night, and usually one to two hours after bedtime. Cluster periods usually are followed by remission periods when the headaches stop. Remission periods can last from months to years.

A cluster headache strikes quickly, usually without warning, although you might first have migraine-like nausea and aura. Common signs and symptoms during a cluster headache include excruciating pain that is generally situated in, behind or around one eye but may radiate to other areas of your face, head and neck; one-sided pain; restlessness; excessive tearing; redness of your eye on the affected side; stuffy or runny nose on the affected side; forehead or facial sweating on the affected side; pale skin or flushing on your face; and drooping eyelid on the affected side.

Men are more likely than women to have cluster headaches, and most people who develop cluster headaches are between 20 and 50, although the condition can develop at any age.

Because the pain of a cluster headache comes on suddenly and might subside within a short time, cluster headache can be difficult to evaluate and treat, as fast-acting medications are required. Treatment seeks to decrease the severity of pain, shorten the headache period and prevent the attacks.