3.1 Cluster headache

Identification: Male patient, 35 years old, engineer, smoker (1 pack/day for 15 years), social drinker. Current Illness History: The patient reports episodes of intense, unilateral pain in the right orbital and temporal region, lasting 30 to 90 minutes, occurring 1 to 2 times a day for approximately 2 weeks. The pain is described as "piercing" or "burning," accompanied by tearing, nasal congestion, and ipsilateral eyelid ptosis. The episodes predominantly occur at night, waking the patient from sleep. He states that the pain is so intense that it makes him agitated, unable to remain still. There is no history of head trauma or recent infections. Past History: Denies previous comorbidities. Negative family history for headaches. Physical Examination: General: Patient is agitated but in good general condition. Neurological: Pupils are isocoric, reactive to light. Slight right eyelid ptosis. No other neurological deficits. ENT: Right nasal mucosa is hyperemic, without purulent discharge. Other systems: No relevant changes.