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Headache, often severe, usually unilateral and periocular and without autonomic symptoms, occurring during and caused by aeroplane travel. It remits after landing.
- At least two episodes of headache fulfilling criterion C
- The patient is travelling by aeroplane
- Evidence of causation demonstrated by at least two of the following:
- headache has developed during the aeroplane flight
- either or both of the following:
- a) headache has worsened in temporal relation to ascent following take-off and/or descent prior to landing of the aeroplane
- b) headache has spontaneously improved within 30 minutes after the ascent or descent of the aeroplane is completed
- headache is severe, with at least two of the following three characteristics:
- a) unilateral location1
- b) orbitofrontal location2
- c) jabbing or stabbing quality3
- Not better accounted for by another ICHD-3 diagnosis4.
- Side-shift between different flights occurs in around 10% of cases.
- Parietal spread may occur.
- Pulsation (throbbing) may also be noted.
- In particular, sinus disorder should be excluded.
A recent Scandinavian survey has indicated that up to 8.3% of air-travellers experience 10.1.2 Headache attributed to aeroplane travel. It occurs during landing in more than 90% of cases.
Accompanying symptoms are reported in up to 30% of cases. Most frequent are restlessness and unilateral tearing; other localized parasympathetic symptoms, nausea or photo/phonophobia have been described in fewer than 5% of cases.
A proportion of subjects experiencing 10.1.2 Headache attributed to aeroplane travel report similar headache during free snorkelling and/or rapid descent from mountains, suggesting these headaches are due to imbalance between intrasinus and external air pressures.