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Cluster Headache F070

Last amended 
Tuesday, November 19, 2019
Current RMA Instruments

Reasonable Hypothesis SOP [1]

57 of 2018

Balance of Probabilities SOP [2]

58 of 2018

Changes from previous Instruments

SOP Bulletin 203 [3]

ICD Coding
  • ICD-9-CM Codes: 346.2
  • ICD-10-AM Codes: G44.0
Brief description

Cluster headache manifests as unilateral, typically severe headache attacks, occurring in clusters.  In the episodic form attacks occur over a period of weeks followed by a remission that may last for months.  There is also a chronic form, without significant remission periods.  Attacks are typically accompanied by autonomic symptoms (usually involving the eye, nose or facial skin).  Whilst rare, cluster headache is the most common form of a group of headache entities, known as the trigeminal autonomic cephalalgias.

Confirming the diagnosis

This diagnosis is made on clinical grounds, using diagnostic criteria.  Neuroimaging is not required (but may be undertaken to exclude a cranial lesion) and other tests are not diagnostically helpful.  Specialist opinion will generally be required.

The relevant medical specialist is a neurologist.

Additional diagnoses that are covered by SOP
  • Cluster headache following head trauma
  • Histamine cephalgia
  • Horton’s neuralgia
Conditions that are excluded from SOP
  • Headaches due to intracranial structural anomalies - code to anomaly
  • Headaches due to systemic disease - code to underlying disease
  • Hemicrania continua #
  • Migraine*
  • Paroxysmal hemicrania#
  • Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) #
  • Short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) #
  • Trigeminal neuralgia*

* another SOP applies

# non-SOP condition

Clinical onset

Clinical onset will be based on when typical cluster headache symptoms, as per the SOP definition, first manifest.   

Clinical worsening

Cluster headache is an enduring condition in most patients.  Preventive therapies can suppress attacks over the duration of a cluster period.  Therapies aimed at preventing onset of cluster episodes are generally ineffective. Worsening may be evidenced by an increase in the frequency, severity or duration of cluster episodes.

 

 

 

Rulebase for cluster headache

Place holder node for Rulebase for cluster headache

Alcohol dependence

Cluster headache - Alcohol dependence Factor

Last reviewed for CCPS 25 April 2000.

Investigative Documents

Claimant Report - Alcohol Consumption [CRD904]

[5] Claimant Report - Alcohol Consumption [CRV904]

Preliminary questions [29852]

[6]29877

there is some evidence that alcohol dependence may be a factor in the worsening of the condition under consideration.

29878 [6] the veteran has suffered from alcohol dependence at some time.

7334 [7] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]29888

the veteran was suffering from alcohol dependence, involving continuing daily consumption of alcohol, at the time of the clinical worsening of the condition under consideration.

29880 — the veteran has established the causal connection between the alcohol dependence and VEA service for the clinical worsening of the condition under consideration.

29881 — the veteran has established the causal connection between the alcohol dependence and operational service for the clinical worsening of cluster headache syndrome.

or

29882 — the veteran has established the causal connection between the alcohol dependence and eligible service for the clinical worsening of cluster headache syndrome.

Clinical worsening and operational service [29881]

29889 — the alcohol dependence is causally related to operational service. [10] [11]

[12]29883

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the alcohol dependence is causally related.

Clinical worsening and eligible service [29882]

29890 — the alcohol dependence is causally related to eligible service. [13] [11]

[14]29884

the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the alcohol dependence is causally related. [15]

No appropriate clinical management for cluster headache syndrome

Cluster headache - No appropriate clinical management for cluster headache syndrome Factor

Last reviewed for CCPS 25 April 2000.

Investigative Documents

Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM]

Preliminary questions [32582]

11109 — the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.

[16]7066

there is some evidence that an inability to obtain appropriate clinical management for the condition under consideration may be a factor in the worsening of the condition under consideration.

7334 [7] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]7378

the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.

7379 [17] the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration.

11234 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration.

11235 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration.

or

11236 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration.

Clinical worsening and operational service [11235]

[18]7384

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service.

[19]21084

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service, as a causal result of operational service.

[20]7387

the veteran's inability to obtain appropriate clinical management for the condition under consideration during operational service was due to the veteran's serious default, wilful act or serious breach of discipline.

or

[21]7389

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.

7390 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service. [22] [23]

[24]7392

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related.

Clinical worsening and eligible service [11236]

[25]7385

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service.

[26]7386

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service, as a causal result of eligible service.

[27]7388

the veteran's inability to obtain appropriate clinical management for the condition under consideration during eligible service was due to the veteran's serious default, wilful act or serious breach of discipline.

or

[21]7389

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.

7391 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service. [22] [23]

[28]7393

the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related. [29]

Trauma to the forehead or temple or eye socket

Cluster headache - Trauma to the forehead or temple or eye socket Factor

Last reviewed for CCPS 25 April 2000.

Investigative Documents

Claimant Report - Cluster Headache Syndrome - Trauma to the Forehead or Temple or Eye Socket [CR9164]

[30] Medical Report - Cluster Headache Syndrome - Trauma to the Forehead or Temple or Eye Socket [MR9239]

Preliminary questions [29851]

[31]29835

the veteran has suffered trauma to the forehead, temple or eye socket at some time.

[32]29839

the veteran suffered trauma to the side of the forehead, temple or eye socket affected by the condition under consideration.

29834 — the veteran has established the causal connection between the trauma to the forehead, temple or eye socket and VEA service for the clinical onset of cluster headache syndrome.

29836 — the veteran has established the causal connection between the trauma to the forehead, temple or eye socket and operational service for the clinical onset of cluster headache syndrome.

or

29837 — the veteran has established the causal connection between the trauma to the forehead, temple or eye socket and eligible service for the clinical onset of cluster headache syndrome.

Clinical onset and operational service [29836]

[33]29838

the clinical onset of the condition under consideration occurred on operational service or within 28 days following a period of operational service.

[34]29841

on operational service, the veteran suffered trauma to the side of the forehead, temple or eye socket affected by the condition under consideration.

[35]29840

on operational service, the veteran suffered trauma to the side of the forehead, temple or eye socket affected by the condition under consideration within the 28 days immediately before the clinical onset of the condition under consideration.

[36]29842

the trauma to the forehead, temple or eye socket that the veteran suffered on operational service within the 28 days immediately before the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.

or

[21]29843

the veteran suffered trauma to the side of the forehead, temple or eye socket affected by the condition under consideration as a result of an illness or injury which is identifiable.

[37]29848

as a consequence of the identified illness or injury, the veteran suffered trauma to the side of the forehead, temple or eye socket affected by the condition under consideration within the 28 days immediately before the clinical onset of the condition under consideration.

29844 — the identified illness or injury which caused the trauma to the forehead, temple or eye socket is causally related to operational service. [38] [39]

Clinical onset and eligible service [29837]

[40]29845

the clinical onset of the condition under consideration occurred on eligible service or within 14 days following a period of eligible service.

[41]29873

on eligible service, the veteran suffered trauma to the side of the forehead, temple or eye socket affected by the condition under consideration.

[42]29874

on eligible service, as a causal result of eligible service duties, the veteran suffered trauma to the side of the forehead, temple or eye socket affected by the condition under consideration.

[43]29846

as a causal result of eligible service duties, the veteran suffered trauma to the side of the forehead, temple or eye socket affected by the condition under consideration within the 14 days immediately before the clinical onset of the condition under consideration.

[44]29847

the trauma to the forehead, temple or eye socket that the veteran suffered on eligible service within the 14 days immediately before the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.

or

[21]29843

the veteran suffered trauma to the side of the forehead, temple or eye socket affected by the condition under consideration as a result of an illness or injury which is identifiable.

[37]29849

as a consequence of the identified illness or injury, the veteran suffered trauma to the side of the forehead, temple or eye socket affected by the condition under consideration within the 14 days immediately before the clinical onset of the condition under consideration. [45]

29850 — the identified illness or injury which caused the trauma to the forehead, temple or eye socket is causally related to eligible service. [46] [39]

Treatment with nitroglycerine or acetazolamide

Cluster headache - Treatment with nitroglycerine or acetazolamide Factor

Last reviewed for CCPS 25 April 2000.

Investigative Documents

Medical Report - Cluster Headache Syndrome - Drug Treatment [MR9238]

Preliminary questions [29853]

[47]29857

there is some evidence that undergoing treatment with nitroglycerine or acetazolamide may be a factor in the worsening of the condition under consideration.

7334 [7] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]29858

the veteran has undergone treatment with nitroglycerine or acetazolamide at some time.

[48]29859

the veteran was undergoing treatment with nitroglycerine or acetazolamide, at the time of the clinical worsening of the condition under consideration.

[49]30077

the veteran was undergoing treatment with nitroglycerine or acetazolamide, at the time of the clinical worsening of the condition under consideration, for an illness or injury which is identifiable.

[50]29860

the treatment with nitroglycerine or acetazolamide for the identified illness or injury at the time of the clinical worsening of the condition under consideration was able to be ceased or substituted.

29861 — the veteran has established the causal connection between the treatment with nitroglycerine or acetazolamide and VEA service for the clinical worsening of the condition under consideration.

29862 — the veteran has established the causal connection between the treatment with nitroglycerine or acetazolamide and operational service for the clinical worsening of the condition under consideration.

or

29863 — the veteran has established the causal connection between the treatment with nitroglycerine or acetazolamide and eligible service for the clinical worsening of the condition under consideration.

Clinical worsening and operational service [29862]

29864 — the identified illness or injury for which the treatment with nitroglycerine or acetazolamide was undergone is causally related to operational service. [51] [52]

[53]29875

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury for which the treatment with nitroglycerine or acetazolamide was undergone is causally related.

Clinical worsening and eligible service [29863]

29865 — the identified illness or injury for which the treatment with nitroglycerine or acetazolamide was undergone is causally related to eligible service. [54] [52]

[55]29876

the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury for which the treatment with nitroglycerine or acetazolamide was undergone is causally related. [56]

Source URL (modified on 23/01/2020 - 12:30pm): https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/c-d/cluster-headache-f070-g440

Links
[1] http://www.rma.gov.au/assets/SOP/2018/057.pdf
[2] http://www.rma.gov.au/assets/SOP/2018/058.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20203_0.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/63420%23comment-form
[5] https://clik.dva.gov.au/ccpsclaimant-21
[6] https://clik.dva.gov.au/ccpsf070rc
[7] https://clik.dva.gov.au/node/69461
[8] clikpopup://CCPS/Reject/OnsetAfterService
[9] clikpopup://CCPS/Reject/NoPermanentWorsening
[10] clikpopup://CCPS/reject29888No
[11] clikpopup://CCPS/reject29889,29890No
[12] clikpopup://CCPS/Onset of the condition under consideration occurred prior to operational service to which the alcohol dependence is causally related
[13] clikpopup://CCPS/reject29883No
[14] clikpopup://CCPS/Onset of the condition under consideration prior to eligible service to which the alcohol dependence is causally related
[15] clikpopup://CCPS/reject29884No
[16] https://clik.dva.gov.au/ccpsother-31
[17] clikpopup://CCPS/Cluster headache syndrome/ACM - contributed to worsening
[18] clikpopup://CCPS/ACM/NoContribution
[19] clikpopup://CCPS/ACM/NotOpService
[20] clikpopup://CCPS/ACM/NotOperDuties
[21] clikpopup://CCPS/rejectwilful
[22] clikpopup://CCPS/ACM/NoIllness
[23] clikpopup://CCPS/reject7390,7391No
[24] clikpopup://CCPS/Cluster headache syndrome/ACM - onset prior to operational service
[25] clikpopup://CCPS/ACM/OnsetFailOper
[26] clikpopup://CCPS/ACM/NotEligService
[27] clikpopup://CCPS/ACM/NotEligDuties
[28] clikpopup://CCPS/Cluster headache syndrome/ACM - onset prior to eligible service
[29] clikpopup://CCPS/ACM/OnsetFailElig
[30] https://clik.dva.gov.au/ccpsclaimant-169
[31] https://clik.dva.gov.au/ccpsf070rc-6
[32] clikpopup://CCPS/reject29835No
[33] clikpopup://CCPS/reject29839No
[34] clikpopup://CCPS/reject29838No
[35] clikpopup://CCPS/reject29841No
[36] clikpopup://CCPS/reject29840No
[37] clikpopup://CCPS/reject29843No
[38] clikpopup://CCPS/reject29848No
[39] clikpopup://CCPS/reject29844,29850No
[40] clikpopup://CCPS/Onset of the condition under consideration on or within 14 days following a period of eligible service
[41] clikpopup://CCPS/reject29845No
[42] clikpopup://CCPS/reject29873No
[43] clikpopup://CCPS/reject29874No
[44] clikpopup://CCPS/reject29846No
[45] clikpopup://CCPS/reject29849No
[46] clikpopup://CCPS/reject29850No
[47] https://clik.dva.gov.au/ccpsmedical-79
[48] clikpopup://CCPS/reject29858No
[49] clikpopup://CCPS/reject29859No
[50] clikpopup://CCPS/reject30077No
[51] clikpopup://CCPS/reject29860Yes
[52] clikpopup://CCPS/reject29864,29865No
[53] clikpopup://CCPS/Onset prior to operational service for identified illness or injury which treatment with nitroglycerine or acetazolamide causally related
[54] clikpopup://CCPS/reject29875No
[55] clikpopup://CCPS/Onset prior to eligible service for identified illness or injury which treatment with nitroglycerine or acetazolamide causally related
[56] clikpopup://CCPS/reject29876No