Optimal management of airplane headache (AH) is still unresolved. A female, 53 years, complained of severe short-lasting jabbing pain attacks over the forehead and in the eyebrows, mainly on the left side, that occur during take-off and landing. Neurological, opthalmological, and otolaryngological examinations and brain MRI were normal. It was diagnosed as AH. The patient was recommended to take 10 mg rizatriptan 30 min before the flight. It resulted in a complete absence of headache during the take-off and significant decrease of pain intensity during the plane descending. Based on the flight duration (about 2.5 h) and rizatriptan pharmacokinetics, the patient was recommended to take a second dose of rizatriptan 10 mg 1 h before flight ending. The patient reported a complete absence of pain attacks during the next flights. The effectiveness of AH pain attack prevention is based on the pharmacokinetic properties of the drug, time of pain onset during flight, and the flight duration.
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http://dx.doi.org/10.1159/000515571 | DOI Listing |
Aerosp Med Hum Perform
October 2024
Neurol Clin
May 2024
Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, University of Toronto; Gladstone Headache Clinic, 1333 Sheppard Avenue E, Suite 122, North York, Ontario M2J1V1, Canada.
Migraine is a common condition that can carry considerable risk to aeromedical duties. Because randomized controlled trials are not an appropriate method to evaluate flight safety risk for medical conditions that may cause subtle or sudden incapacitation, the determination of fitness-to-fly must be based on risk assessments informed by extrapolated evidence. Therefore, we conducted a review of current literature to provide background information to inform the aeromedical risk assessment of migraine using a risk matrix approach.
View Article and Find Full Text PDFBMJ Case Rep
January 2024
Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA.
We report a case of the formation of a dural arteriovenous fistula (dAVF) of the transverse-sigmoid sinus following venous sinus stenting (VSS), treated with trans-arterial embolisation and venous remodelling. An obese woman in her 30s presented with persistent daily headaches after undergoing endoscopic repair of a skull base cerebrospinal fluid leak. Angiography demonstrated a focal right transverse-sigmoid sinus stenosis, and she underwent VSS of the right transverse sinus.
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