A 33-year-old man comes to the emergency department because of repeated episodes of severe headache for the past 3 days. He is currently having his 2nd episode of the day. He usually has his first episode in the mornings. The pain is severe and localized to his right forehead and right eye. He had similar symptoms last summer. Physical examination shows drooping of the right eyelid, tearing of the right eye, and rhinorrhea. Which of the following is the most likely cause of this patient's current symptoms?

Question

Quizplus · Accepted Answer

Eductional Objective: Cluster headaches cause severe, episodic, unilateral periorbital and temporal pain associated with ipsilateral autonomic symptoms (eg, lacrimation, nasal congestion, miosis, conjunctival injection).  The headaches typically last 15-180 minutes and tend to occur in clusters (often at the same time each day).  Males are affected more commonly than females.

A 33-Year-Old Man Comes to the Emergency Department Because of Repeated