Objectıve

Cluster headache (CH) is a coronavirus 2019 (COVID-19) vaccination-related adverse event. There are a few case reports of relapses or de novo cluster episodes following the vaccine. The disease's pathophysiology is still not clear. The most widely accepted mechanism is activation of the trigeminocervical complex (TCC). However, the correlation between vaccination and CH is unexplainable. Its goal is to compare the CH bouts of patients before and after the vaccine.

Methods

Patients with a history of CH and who had never experienced COVID-19 illness during the pandemic were included in this retrospective cohort analysis. The semi-structured survey was administered face to face to 24 CH patients (16 male). The headache features before and after vaccination were detailed in this survey.

Results

18 patients got vaccinated twice, and 6 of them had no vaccination. After the first vaccination, 83.3% of them had CH bout; after the second vaccination, 72.2% of them had CH bout. We divided headache episodes into three groups: (1) before vaccination, (2) after the first vaccination, and (3) after the second vaccination. The third group had a higher pain intensity (9.30 ± 0.630, p = 0.047) and remitting longer (20.00 ± 5.40 days, p = 0.019) than the other groups. The management of the 53.3% bouts after vaccinations was less effective than the usual episodes.

Conclusion

Most ECH patients experienced new bouts more intense and longer duration after vaccinations than their previous bouts, the mechanism, and pathogenesis of the bouts are the subject of future research. The new studies can be a light for understanding the CH pathophysiology more deeply.

中文翻译：

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一项回顾性队列研究：COVID-19 BNT162b2 mRNA 疫苗接种是丛集性头痛的触发因素吗？

客观的

丛集性头痛 (CH) 是一种与 2019 年冠状病毒 (COVID-19) 疫苗接种相关的不良事件。有一些疫苗接种后复发或从头聚集性发作的病例报告。该病的病理生理学仍不清楚。最广泛接受的机制是三叉颈复合体（TCC）的激活。然而，疫苗接种与 CH 之间的相关性无法解释。其目标是比较患者接种疫苗前后的慢性肝炎发作情况。

方法

本次回顾性队列分析纳入了有 CH 病史且在大流行期间从未患过 COVID-19 疾病的患者。这项半结构化调查是面对面对 24 名 CH 患者（16 名男性）进行的。本次调查详细介绍了接种疫苗前后的头痛特征。

结果

18名患者接种了两次疫苗，其中6人未接种疫苗。第一次接种后，83.3%的人出现CH发作；第二次接种后，72.2%的人出现CH发作。我们将头痛发作分为三组：（1）疫苗接种前，（2）第一次疫苗接种后，（3）第二次疫苗接种后。 与其他组相比，第三组的疼痛强度更高（9.30 ± 0.630，p  = 0.047），缓解时间更长（20.00 ± 5.40 天，p = 0.019）。 53.3% 的疫苗接种后发作的管理效果不如通常发作。

结论

大多数 ECH 患者在接种疫苗后会经历比之前的发作更强烈、持续时间更长的新发作，其机制和发病机制是未来研究的主题。新研究可为更深入地了解 CH 病理生理学提供线索。