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Original Article
- Adult-Onset versus Pediatric-Onset Episodic Cluster Headaches: Results from the Korean Cluster Headache Registry
- Pil-Wook Chung, Byung-Su Kim, Jeong-Wook Park, Jong-Hee Sohn, Mi Ji Lee, Byung-Kun Kim, Min Kyung Chu, Tae-Jin Song, Soo-Kyoung Kim, Heui-Soo Moon, Kyungmi Oh, Soo-Jin Cho
- Headache Pain Res. 2026;27(1):64-70. Published online February 13, 2026
- DOI: https://doi.org/10.62087/hpr.2025.0021
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Abstract
PDF - Purpose: This study aimed to compare clinical characteristics between pediatric-onset and adult-onset cluster headache (CH) using data from the Korean Cluster Headache Registry, a nationwide, prospective, multicenter registry.
Methods
This cross-sectional observational study analyzed data collected over a 4-year period from a prospective multicenter registry. A total of 337 patients aged ≥19 years with episodic CH were included. Participants were classified as having pediatric-onset CH (onset≤18 years) or adult-onset CH (onset>18 years). Demographic and clinical features, smoking status, and psychiatric comorbidities were compared between groups.
Results
Pediatric-onset CH was reported in 24.6% of patients (n=83). The diagnostic delay was significantly longer in the pediatric-onset group compared with the adult-onset group (10.1 years vs. 6.2 years, p<0.001). Patients with pediatric-onset CH experienced more severe headache attacks (numerical rating scale 9.2 vs. 8.9, p=0.025), although attack duration, frequency, and other clinical features were similar between groups. Smoking exposure was lower in the pediatric-onset group, suggesting potential differences in environmental risk factors. No significant differences were observed in psychiatric comorbidity or headache-related disability.
Conclusion
Pediatric-onset CH is relatively common and shares most clinical features with adult-onset CH, apart from greater attack severity and lower smoking exposure. The longer diagnostic delay in pediatric-onset cases highlights the need for improved awareness and earlier recognition. Further research is warranted to elucidate the underlying pathophysiological mechanisms and long-term outcomes in pediatric-onset CH.
Reiview Article
- Diagnosis and Exclusion of Dangerous Headache in Headache Clinic Patients
- Jiyoung Kim, Kyoung Jin Hwang
- Korean J Headache. 2023;24(1):11-16. Published online June 30, 2023
- 710 View
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Abstract
PDF
- There are many different types of headaches, but they can be broadly classified as primary and secondary headaches. The Diagnosis of Headaches involves understanding the epidemiology of headaches, identifying the signs of secondary headaches, and applying the diagnostic criteria outlined in the International Classification of Headache Disorders. Clinicians should have a clear understanding of SNNOOP10 to indicate secondary headache. Furthermore, the evaluation of patients who present with a thunderclap headache should be conducted with great care and detail.
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