title: Errors in recognition and management are still frequent in patients with cluster headache.
abstract: OBJECTIVE
  To analyze the trajectory to diagnosis and information provided in a series of cluster headache (CH) patients from five headache clinics.
  
  
  METHODS
  CH patients were asked to fill in an ad hoc questionnaire.
  
  
  RESULTS
  Seventy-five patients (mean age 41.5 years, 67 males) completed the questionnaire. Patients had visited during an average of 4.9 years a mean of 4.6 physicians who had obtained 2.5 neuroimaging procedures per patient before getting a diagnosis of CH. Sixty-three (84%) had received no diagnosis (21 cases; 28%), while 43 (57%) had been given an average of 2.1 alternative diagnoses. Migraine, trigeminal neuralgia and sinusitis were the most frequent mistakes. After diagnosis, 55% had subjectively received poor/very poor information on CH. Ninety-five percent had poor or incorrect information about the nature of the disease, or acute (70%) and preventive (61%) treatments. Etiology (90%), management options (36%) and potential adverse events of medications (29%) were their main information demands.
  
  
  CONCLUSIONS
  Although CH is an invalidating and clinically clear-cut disorder suffered by around 1/1,000 people, it is still frequently unrecognized and/or mistaken for other disorders, which calls for a better knowledge and education in the diagnosis of the main primary headaches.
authors.affiliation: Service of Neurology, Ruber International Hospital, Madrid, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Sánchez Del Rio
authors.forename: Rogelio
authors.initials: R
authors.lastname: Leira
authors.forename: Patricia
authors.initials: P
authors.lastname: Pozo-Rosich
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Laínez
authors.forename: Rocío
authors.initials: R
authors.lastname: Alvarez
authors.forename: Julio
authors.initials: J
authors.lastname: Pascual
mesh_terms: D000328:Adult; D000368:Aged; D003027:Cluster Headache / Q000175:diagnosis* / Q000628:therapy*; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D055815:Young Adult