Comments on: What’s all this fuss about oxygen?

By: motorcycle tire changer attachment

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By: Sean

Sean — Mon, 02 Jan 2012 18:36:39 +0000

My first cluster headache occurred during internship. I had no idea what it was, so my initial experience was something like you describe, Richard.

I am a neurologist and can tell you the mainstream view in neurology is that there is no connection between CH and PTSD. There may be some association in the VA data, but there are many reasons why this might be that do not imply causation at all. I believe Dr. Sewell was referring to abnormalities in circuits involving the amygdala in PTSD, not CH.

I am not aware of any medical literature linking the two – although it is hard to say with the VA system – it is unlikely it would be considered service-connected in any way. It is much more likely an idiopathic condition, just like my CH.

From a practical perspective (if you don’t have other insurance resources) it is probably best to pursue the other service connected disabilities. Once you are considered by the VA system to be “service connected” you may be able to obtain treatment for other conditions such as the CH. This can be quite expensive if you have to use sumatriptan injections, and well worth trying to obtain coverage.

If you are not able to obtain coverage, some of the prophylactic medications used are very inexpensive, and welding oxygen rather than imitrex or medical oxygen can be used. You should discuss cost issues with your neurologist if you end up in that situation.

Good Luck

By: Richard

Richard — Mon, 12 Dec 2011 06:27:52 +0000

My experience has been; Cluster Headaches maybe twice a year after returning from Vietnam. At first, I though they were REALLY BAD hangovers! Then, after leaving the Marine Corps, the frequency of the headaches increased over the years. Quarterly – then Monthly – Weekly – now, not only daily, but up to three times in a day. Sometimes, it’s at 5:30 am, then again at 5:30ish pm. I’ll get them in almost exact 12-hour periods. The MOST relief I’ve had in years, is three days in a row without one. Needless to say my life, as I knew it, is in ruins.
Your comment about the amygdala is the FIRST time I have heard of it in reference to CHA. Is this new data?
Doctor, I am NOT contesting your comment, I just need to understand. I need to know what’s happening to me, and if possible– Why.
Thank you so VERY much for your time Dr. Sewell. It IS appreciated.
Richard.

By: szklane

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By: Sandi Suddaby

Sandi Suddaby — Fri, 02 Dec 2011 02:19:35 +0000

I firmly believe cluster headaches cause PTSD. If one gets a little break from them, it’s like looking over your shoulder to see if one is lurking; the least little twinge and you say oh no not again. (and yes, it is there again!)
My sympathy to our veterans with PTSD – their memories are far more ghastly…not that I downplay the pain of CH.
Thank you Dr. Sewell.

By: asewell

asewell — Wed, 30 Nov 2011 18:34:57 +0000

Do tell?

By: asewell

asewell — Mon, 21 Nov 2011 22:09:54 +0000

PTSD is more a problem with the amygdala than it is the hypothalamus, although the amygdala does project to the hypothalamus, so abnormality in one will affect the other (in this case, increased production of stress hormones that are triggered by hypothalamic activation). Some authors have suggested that patients with cluster headache can get PTSD from their cluster attacks. Nobody really thinks that PTSD causes cluster headache, though. That’s probably why your doctor was being stubborn. What’s your experience?

By: prezenty

prezenty — Tue, 15 Nov 2011 02:36:34 +0000

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By: Richard

Richard — Sat, 12 Nov 2011 19:32:45 +0000

Dr. Sewell,
It has been almost a year since we have corresponded about ” PTSD + Hypothalamus = Cluster Headaches.”
I am currently being evaluated by the VA for PTSD, Depression, and Cluster Headaches. The Doctor I saw last week would NOT accept any correlation of PTSD effecting the Hypothalamus and CHA coming from the Hypothalamus.
Have you seen any more data showing that eluding to this?

By: asewell

asewell — Tue, 21 Dec 2010 15:41:58 +0000

Hi Richard–

It’s a good question. A history of head injury with loss of consciousness will double your chances of having a cluster headache. I wasn’t able to find any studies on a link between PTSD and cluster headache. However, since I work at a VA hospital, I went through the VA database to see if I could find a link. Of the 2048 veterans with cluster headache who sought care at the VA in 2009, the odds that one of them has PTSD is 2.46 (95% confidence interval 2.33 to 2.60) compared to the 385,502 veterans who did not have cluster headache. Correlation does not imply causation, however–it’s not clear whether PTSD will increase your chances of having cluster headache, or whether cluster headache increases your chances of getting PTSD. However, this is the VA’s own data. Hope that helps!–Dr. Sewell