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....i'm saying i have never seen it reported...but absolutes re CH do not exist...if there are fixed/visible physical manifestations, it would seem they are rare...i would not take that to mean there is no evidence. mostly talking the dreaded brain scan, while also noting that the pupil of my affected side eye is permanently constricted. eye docs/neuros just shrug... ....since it was well known at work that "jon has CH"....i was approached by folks suffering from "headaches" of various kinds on a fairly regular basis. one friend of a friend had many of the classic symptoms of CH (unilateral, excruciating, autonomic symptoms, same daily timing. etc) and i was asked "is this cluster headache?". sure sounded like it, but i am NOT a physician, refused to say, and strongly urged a visit to a neuro and "a scan to rule out potential underlying causes". a careful diagnostician would consider this routine (and one of the reasons to find a HA specialist). he took that advice and it turned out to be a rapidly growing tumor that was life threatening...found/removed in time. i do not know the details of location....and i do not wish to alarm....so you are on the right path to eliminating other cause with the neuro visit...

I've seen @CHfather mention Hemicrania continua a few times as being somewhat similar and often misdiagnosed cases between CH and HC .. I hadent heard of it prior to his mentioning. When looking the condition up it seems to be close. I believe he mentioned a test of sorts with medication that is effective for HC but not CH...

Again, this is about migraine, but the emphatic point from a leading headache expert is that WMLs are essentially inconsequential. In the case of migraine, it does seem that people with migraine are somewhat more likely to develop WMLs. https://americanmigrainefoundation.org/resource-library/migraine-and-brain-lesions/

Thank you again, all, for the info! It is really helpful!

...yeah...THIS! ...for reasons other than CH i've had multiple scans of various kinds.....nearly every one shows "something" that draws comments re potential causes. it's radiologist CYA and always scared the spit out of me until i came across a urologist who bemoaned that....and another physician who said "we ALL have "anomalies" ...you are more likely to die with than from....a scan in and of itself is rarely determinative of anything". ...do your research, i did, but use it to ask questions rather than come to scary conclusions... ...fwiw...and this is a personal observation based on years of being in the clusterhead community. there are conditions that mimic CH symptoms...and which makes a diagnostic scan worthwhile, but, i've never seen any lit that describes CH being a causative factor in scan anomalies...

It would be foolish for me to say it's nothing to worry about, but . . . "White matter lesions are among the most common incidental findings—which means the lesions have no clinical significance—on brain scans of people of any age." https://www.brainandlife.org/articles/what-are-white-matter-lesions-are-they-a-problem My daughter's first MRI for CH, more than ten years ago, showed some WMLs. Nothing bad has happened to her in that regard. People with migraine have white-matter lesions more often than other people. Imma guess that's probably true for people with CH, too.

Hi HCF, I had something similar with my last MRI.. exact wording was (Overall unremarkable MRI of the brain. Tiny foci of T2/FLAIR signal abnormality within the RT external capsule is likely of little clinical significance.) When I spoke to my neuro he explained it to be "white matter" most likely some scaring/scar tissue. I certainly can believe that these bangers have caused some scaring... He also mentioned that it can be somewhat common in people with migraine or CH. I did the same research thing that you are doing and only scared myself worse than I needed to. Talk to your neuro about it and you will most likely feel much more at ease. It's really easy to research yourself into a fright.