In reference to “Optimal deep brain stimulation site and target connectivity for chronic cluster headache,” Dr. Gupta suggests that patients should fail a trial of indomethacin, at appropriate dose and over an adequate time period, before surgical intervention is considered for cluster headache. Authors Akram et al. contend that patients presenting with the cluster headache phenotype, and who respond to indomethacin, should be classified as having paroxysmal hemicranias based on the International Classification of Headache Disorders, 3rd edition.
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