10.1.2 Headache attributed to aeroplane travel

Description:
Headache, often severe, usually unilateral and periocular and without autonomic symptoms, occurring during and caused by aeroplane travel. It remits after landing.

Diagnostic criteria:
A. At least two episodes of headache fulfilling criterion C
B. The patient is travelling by aeroplane
C. Evidence of causation demonstrated by at least two of the following:

    1. headache has developed exclusively during aeroplane travel
    2. either or both of the following:

      a) headache has worsened in temporal relation to ascent after take-off and/or descent prior to landing of the aeroplane
      b) headache has spontaneously improved within 30 min after the ascent or descent of the aeroplane is completed

    3. headache is severe, with at least two of the following three characteristics:

      a) unilateral location
      b) orbitofrontal location (parietal spread may occur)
      c) jabbing or stabbing quality (pulsation may also occur)

D. Not better accounted for by another ICHD-3 diagnosis.

Comments:
10.1.2 Headache attributed to aeroplane travel occurs during landing in more than 85% of patients. Side-shift between different flights occurs in around 10% of cases. Nasal congestion, a stuffy feeling of the face or tearing may occur ipsilaterally, but these have been described in fewer than 5% of cases.

The presence of a sinus disorder should be excluded.