On behalf of statements of a Cluster Headache Questionnaire recently published the Journal of headache and current guidelines, Oxygen should be considered as the first-line therapy to manage cluster headache despite age. Generally, the extensive international surveys of cluster headache are very unusual. This analysis manifests the data from the Cluster Headache Questionnaire involved respondents from over 50 countries. The approaches that were taken in this survey for consideration were Oxygen, emerging medications like intranasal Ketamine and opioids. The main focus was given towards the respondents who were of 65 years old or older.

The survey was an internet-based survey which comprised questions based on diagnostic criteria as well as regarding the efficacy of medicines, difficulty obtaining medications, mood scores, emotional, psychological, physical and medical complications. The diagnostic questions were also employed to form another group of respondents with probable cluster headache. The lack of a formal clinical diagnosis of cluster headache, the grouping of some medications and the use of nonvalidated questions were some of the limitations of this survey.

Out of the entire 3251 participated patients, 2193 met criteria. 78.0% of the respondents exhibited episodic cluster headache. Over half of the participants described a complete or very efficient treatment for Oxygen and triptans. For caffeine, intranasal Ketamine, energy drinks, and ergot derivatives,  14 and 25% participants responded complete or very effective outcomes. Only 10% or less than showed outcomes for intranasal Lidocaine, intranasal Capsaicin, and opioids. The approaches Oxygen, Caffeine, intranasal Capsaicin, intranasal Lidocaine, energy drinks, and intranasal Ketamine showed less adverse effects in comparison to Opioids, Triptans, Ergotamine/Cafergot, and Dihydroergotamine. As compared to participants with a full diagnosis of cluster headache, the 589 participants with expected cluster headache described relative efficacy. Out of all above regimens, Oxygen proved to be the highly effective treatment.