Clinical characteristics of 104 patients with cluster headache: a single-center cross-sectional study

Objective To analyze the clinical characteristics of patients with cluster headache (CH). Methods Between January 2021 and March 2026, a total of 135 patients with suspected CH who first visited the headache outpatient clinic at Central Hospital of Dalian University of Technology (Dalian Municipal Central Hospital) for headache attacks were enrolled. After excluding 31 patients who did not meet the eligibility criteria (secondary headache or incomplete data), the clinical data of the remaining 104 patients were analyzed. Results (1) All 104 patients completed the follow-up, with a male-to-female ratio of 4.2:1, and 97.11% were diagnosed with episodic CH (eCH). (2) Depression and anxiety were significantly more prevalent in females ( p = 0.004 for both), and Sleep disorders also showed a significantly higher prevalence in females (70.00% vs. 42.86%, p = 0.029). (3) Among male patients, right-sided attacks were the most common laterality (54/84, 64.29%), whereas among female patients, left-sided attacks predominated (14/20, 70%). Alternating bilateral attacks occurred exclusively in four female patients (20% of females). (4) A circadian pattern was observed in 82.69% of patients, and the predominant time of onset was the afternoon (12:00–17:00). (5) 7.69% (8/104) of patients experienced no autonomic symptoms; their accompanying features included agitation with nausea, agitation with phonophobia/photophobia, or agitation alone. Conclusion This study provides a comprehensive analysis of the clinical characteristics, comorbidity patterns, attack features, and accompanying symptoms of CH in the Dalian region. It enhanced local physicians’ awareness of cluster headache, which may help reduce misdiagnosis, shorten the time to diagnosis, and improve patients’ quality of life.