Which type of headache is suggested by an excruciating headache, nasal congestion, and excessive eye watering?

The presence of an excruciating headache, nasal congestion, and excessive eye watering strongly indicates a cluster headache. Cluster headaches are characterized by severe, intense pain that often occurs in cyclical patterns or "clusters," typically localized to one side of the head. The pain is often so debilitating that it can severely impact quality of life.

The nasal congestion and tearing of the eyes are hallmark symptoms associated with cluster headaches. These symptoms occur due to the activation of the autonomic nervous system, which results in symptoms similar to those found in an allergic reaction or a cold. This is why individuals experiencing cluster headaches often report these specific accompanying symptoms alongside their intense headache pain.

In contrast, tension-type headaches generally present as a dull, aching sensation rather than excruciating pain, and they do not typically include symptoms like nasal congestion or eye watering. Migraine headaches can also be very painful and may involve other symptoms such as nausea or sensitivity to light, but they do not usually present with the specific combination of nasal congestion and excessive eye watering in the same manner as cluster headaches. Sinus headaches are associated with sinusitis and can cause facial pain related to sinus pressure, but they are distinct from the sharp, localized pain and autonomic symptoms of cluster headaches.