Airplane Headache

“The Case of the Woman Who Did Never Dare to Fly” is the title of a case report in Headache, February 2016, page 389. Oliver Sacks would have enjoyed this. It describes a woman who consistently developed headache during rapid descent by car from mountain elevations of about 6000 feet.

“Headache attributed to airplane travel” is now an established diagnosis in International Classification of Headache Disorders. It is typically severe, unilateral, stabbing or throbbing, usually occurring just prior to landing and lasting 20 to 30 minutes. Yawning may improve it. It is thought to be an imbalance between intrasinusal and external air pressure. This assumption, however, does not explain why it occurs only occasionally and not consistently in an individual. Perhaps the change in pressure is not the direct cause but rather a “trigger,” analogous to that seen in cold pressor (ice cream) headache and other primary headache disorders, such as cough, sexual, exertional headache.

Add this to the many indignities of air travel. Perhaps, pretreating with a low dose of indomethacin may block the headache.

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