Introduction
Cluster headache (CH) is considered a disorder of young men, which predominantly begins at age 20-to-40 years.
Aims
We evaluated the gender distribution in patients with CH aged 65 years and older.
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Methods
For the last 15 years we have observed 261 patients suffering from CH. Out of these cases, 43 patients (16.5% of the whole population) were over 65 years.
Results
In this group of elderly patients, 24 were females and 19 were males. We diagnosed 4 patients with CH (only one bout, according to the International Classification of Headache Disorder), 25 with episodic CH, and 14 with chronic CH. The onset occurred in ages 35-44 years for 21.4% of cases, in ages 45-54 for 16.7%, in ages 55-64 for 28.6% and after the age of 65 years for 33.3%. Notably, in the latter subgroup, the females significantly prevailed, accounting for 78.6% of cases. Out of the patients aged over 65 years the prevalence of chronic CH was remarkably higher (25.6%) than in previous ages (9.5%).
Conclusions
The increasing number of elderly patients with CH could be related to an inadequate recognition of this headache disorder, which has been believed for a long time to affect mainly young subjects. Apparently peculiar to female distribution, an increased frequency of CH appears to occur in middle-age and elderly patients. To our knowledge, we report the patient with the oldest age at onset (a 93-year-old woman) and the largest case series of CH elderly patients published in the literature to date.
No conflict of interest.
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