Cluster Headache - Blood Stasis Pattern

Dr. Li Wei, DACM

Cluster Headache · Blood Stasis Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Head

Pattern Overview

Blood Stasis is a common pattern in cluster headache, characterized by trigeminal vascular activation, neurogenic inflammation, CGRP/PACAP38 release, fixed severe pain, and chronic attacks. The core pathogenesis is Blood stasis in the head collaterals, causing trigeminal vascular activation, neurogenic inflammation, and persistent severe pain.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Fixed severe unilateral pain, chronic attacks, stabbing quality |

| Associated Symptoms | Dark complexion, purple-dark lips, fixed location, poor response to treatment |

| Tongue and Pulse | Purple-dark tongue with petechiae, hesitant pulse |

| Pathogenesis | Blood stasis in the head collaterals |

| Etiology | Chronic cluster headache, inadequate treatment, poor circulation |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Fengchi (GB20) | Depression below the occipital bone, between the sternocleidomastoid and trapezius | Unblocks the head collaterals and relieves pain |

| Taiyang (EX-HN5) | In the depression at the temple | Key point for headache; invigorates blood in the head |

| Hegu (LI4) | Dorsum of the hand, between the 1st and 2nd metacarpals | Regulates Qi and invigorates blood |

| Xuehai (SP10) | On the medial thigh, 2 cun above the patella | Invigorates blood and resolves stasis |

| Ashi points | Tender spots around the head | Local blood invigoration and pain relief |

Clinical Recommendation: Filament needle, reducing method; may combine with cupping on the neck to enhance blood stasis resolution.

Herbal Formula

Base Formula: Tong Qiao Huo Xue Tang (通窍活血汤)

Composition:

Peach Kernel (Tao Ren), Safflower (Hong Hua), Angelica (Dang Gui), Chuanxiong (Chuan Xiong), Red Peony (Chi Shao), Musk (She Xiang), Scallion (Lao Cong), Ginger (Sheng Jiang), Jujube (Hong Zao), Licorice (Gan Cao)

Action: Invigorates blood, resolves stasis, unblocks the orifices, and relieves pain.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe pain | Add Ru Xiang, Mo Yao to relieve pain |

| Dizziness | Add Tian Ma, Gou Teng to calm Liver Wind |

| Dull complexion | Add Dan Shen, San Qi to enhance blood invigoration |

| Qi deficiency | Add Huang Qi, Dang Shen to supplement Qi and invigorate blood |

Western Mechanism Reference

Trigeminal vascular activation causing neurogenic inflammation, with CGRP/PACAP38 release causing vasodilation. Blood Stasis corresponds to chronic cluster headache, where CGRP/PACAP38 release and neurogenic inflammation contribute to persistent severe pain.

References

  1. Internal Medicine of TCM - Headache with Blood Stasis.

  2. Xiong Jibai: Blood Stasis uses Tao Hong Si Wu Tang.

  3. WHO. (2023). Headache disorders. World Health Organization.

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