Airplane Headache – A Unusual Case

Have you heard of an “Airplane Headache?”

You most likely haven’t. An airplane headache is a special kind of headache that only appears in some people during an airline flight.

Whats the big deal, its just a headache? I’m sure your saying. Well this is no ordinary headache. This type of headache has also gone undetected for a long time. And no one knows why some people have this headache.

Here are the results of the Scientific Study: paper published

Background: The ‘headache attributed to airplane travel’, also named ‘airplane headache’ (AH), is a recently described headache disorder that appears exclusively in relation to airplane flights, in particular during the landing phase. Based on the stereotypical nature of the attacks in all reported cases, we proposed provisional diagnostic criteria for AH in a previously published paper. Up to now 37 cases have been described in the literature.

Methods: After our paper was disseminated via the Internet, we received several email messages from subjects around the world who had experienced such a peculiar headache. Their cooperation, by completing a structured questionnaire and allowing the direct observation of three subjects, enabled us to carry out a study on a total of 75 patients suffering from AH.

Results: Our survey confirmed the stereotypical nature of the attacks, in particular with regard to the short duration of the pain (lasting less than 30 minutes in up to 95% of the cases), the clear relationship with the landing phase, the unilateral pain, the male preponderance, and the absence of accompanying signs and/or symptoms. It is conceivable to consider barotrauma as one of the main mechanisms involved in the pathophysiology of AH. The observation that the pain appears inconstantly in the majority of cases, without any evident disorder affecting the paranasal sinuses, could be consistent with a multimodal pathogenesis underlying this condition, possibly resulting in the interaction between anatomic, environmental and temporary concurrent factors.

Conclusions: This is by far the largest AH case series ever reported in the literature. The diagnostic criteria that we previously proposed proved to be valid when applied to a large number of patients suffering from this condition. We support its recognition as a new form of headache, to be included in the forthcoming update of the International Headache Society Classification, within ‘10. Headache attributed to disorder of homoeostasis’. Its formal validation would favour further studies aimed at improving the understanding of its pathophysiology and implementing preventative measures.”

Airplane headaches (AHs) are brought on by airplane travel and afflict some travelers. For a number of reasons, it is difficult to assess how prevalent AHs are. It is possible that patients prone to AH may make lifestyle modifications—such as reducing the number and frequency of flights—to reduce the incidence of the headaches. And, because of the short duration relative to other types of headaches, it is likely that many people who experience AH do not mention it to their doctors.

AHs share several features. In addition to the obvious connection with air travel, they are generally associated with landing, tend to be very painful and throbbing, are usually unilateral, and often resolve after approximately 30 to 60 minutes.

The causative mechanism has not been well established. They are believed to be caused by one of several mechanisms related to physiological responses to the atmospheric pressure changes induced by air flight, including: reversible barotrauma, inflammation, or fluid pressure.”

Interestingly, large systemic studies point to a surprisingly low association between AHs and other diagnoses, such as migraine headaches, tension headaches, and chronic sinus allergies.1 There is also no documented association between AHs and any adverse health risks.

Some patients are especially prone to AH. A study in Denmark2 replicated the AH experience by asking volunteers to enter a pressure chamber, that was set to a similar environment as that of an airplane flight. The volunteers who regularly experienced AHs had the same symptoms when they entered a pressure chamber, while the volunteers who had never experienced AHs did not have symptoms when they entered the pressure chamber.

The study itself was performed for the purpose of identifying biomarkers for AHs. It turned out that the volunteers who had AH-like attacks also had measurable increases in their salivary prostaglandin levels, changes in cortisol levels, and mild changes in oxygen saturation, while the non-headache volunteers did not have these changes.

Treatment and prevention

The majority of AH sufferers do not regularly have headaches, so they do not typically carry headache medication with them when they are not traveling by air. This means that their physician must prescribe or recommend over-the-counter medication specifically for times of travel.

There are no well established or standardized approaches to treatment and prevention of AH. Due to the short duration of these events, medical therapy is generally used within a few hours of the flight. Use of anti-inflammatory medications, triptans, and steroid medications have all been found helpful, based on anecdotal accounts.”

“While most of the sufferers in this study had their first airplane headache while they were in their 30s, the attacks don’t appear to happen every time people fly.

Airplane headache was first described in the medical literature in 2004, and it was viewed as a rare occurrence. But now experts aren’t so sure. “We suppose it’s a common condition,” says Mainardi, but they’ve yet to collect the data to back that up.”

My Personal Experience

Now this may come to a surprise to you, but I have been having these “Airplane Headaches.” This is how I would describe it; Imagine being stabbed or stung right above the eye over and over and over again. You also have no control over the pain and you can’t stop it.

Although this condition is mainly seen in middle-aged people, I have been experiencing it about once out of every two flights. It always happens about ten to twenty minutes before landing. This is a very painful headache, when it occurs the thought that you are going to die crosses your mind at least a few times.

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