Call 911 or other emergency services immediately if:

• You have a very sudden, severe, "thunderclap" headache that seems to come on instantly and is unlike any headache you have had before.
• A headache develops along with stiff neck, high fever, nausea, vomiting, lethargy, drowsiness, and confusion.
• A headache develops along with weakness, paralysis, numbness, visual disturbances, slurred speech, confusion, or behavior changes.
• The intense pain caused by cluster headaches leads to thoughts of suicide. Treatment can help relieve the pain from your headaches.

Call your doctor immediately if:

• Headaches begin abruptly with no previous history of headaches, especially if the pain is sudden and severe.
• Headaches develop after a recent fall or blow to the head.
• A headache develops gradually and occurs with confusion, lethargy, problems with walking, or loss of bladder or bowel control.

Call your doctor if:

• You are repeatedly awakened by a severe headache during the night or in the morning.
• You are 50 years old and are having your first severe headache.
• The pattern of your headaches changes.
• The headaches occur during or after physical exertion, sexual activity, coughing, or sneezing.
• Your headaches do not get better with medication.
• Your headaches are interfering with your daily activities.
• The headaches occur with depression or anxiety.
• You begin having daily headaches that are not relieved with nonprescription pain relievers.
• A child's headaches occur daily or are becoming worse with time.

Not all frequently occurring headaches are cluster headaches. For more information, see the topic Headaches.

Watchful Waiting

Cluster headaches need to be treated with prescription medications, so watchful waiting is not appropriate. If you think you may have cluster headaches, see your doctor.

Who To See

If you think you have cluster headaches, treatment may reduce the frequency and severity of the cycles. The following health professionals can diagnose and treat cluster headaches:

• Family medicine physician
• General practitioner
• Internist
• Neurologist

Headache clinics are also able to evaluate and treat cluster headaches. When looking for the right headache clinic, asking a few questions about the services provided-such as what types of specialists are at the clinic-will help you find the clinic that is best for you.

To prepare for your appointment, see the topic Making the Most of Your Appointment