Sherpas, Coca Leaves, and Planes: High Altitude and Airplane Headache Review with a Case of Post-LASIK Myopic Shift

AbstractPurpose of ReviewHigh altitude headache is a common neurological symptom that is associated with ascent to high altitude. It is classified by the International Classification of Headache Disorders, 3rd Edition (ICHD-3) as a disorder of homeostasis. In this article, we review recent clinical and insights into the pathophysiological mechanisms of high altitude and airplane headache. We also report a second case of post-LASIK myopic shift at high altitude exposure secondary hypoxia. Headache attributed to airplane travel is a severe typically unilateral orbital headache that usually improves after landing. This was a relative recent introduction to the ICHD-3 diagnostic criteria. Headache pain with flight travel has long been known and may have been previously considered as a part of barotrauma. Recent studies have helped identify this as a distinct headache disorder.Recent FindingsPhysiologic, hematological, and biochemical biomarkers have been identified in recent high altitude studies. There have been recent advance in identification of molecular mechanisms underlying neurophysiologic changes secondary to hypoxia. Calcitonin gene –related peptide, a potent vasodilator, has been implicated in migraine pathophysiology. Recent epidemiological studies indicate that the prevalence of airplane headache may be more common than we think in the adult as well at the pediatric population. Simulated flight studies have identified pote ntial biomarkers.SummaryAlthough resear...
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research

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Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research
Am J Perinatol DOI: 10.1055/s-0040-1712170 Objective Emergent postpartum hospital encounters in the first 42 days after birth are estimated to complicate 5 to 12% of births. Approximately 2% of these visits result in admission. Data on emergent visits and admissions are critically needed to address the current maternal morbidity crisis. Our objective is to characterize trends in emergent postpartum hospital encounters and readmissions through chief complaints and admission diagnoses over a 4.5-year period. Study Design All postpartum hospital encounters within 42 days of delivery at our institution from 201...
Source: American Journal of Perinatology - Category: Perinatology & Neonatology Authors: Tags: SMFM Fellowship Series Article Source Type: research
The objective of this narrative review is to familiarize primary care clinicians with the variety of acute treatment options available in the United States today based on clinical trial findings, meta-analyses, evidence-based guidelines, and professional society consensus statements. PMID: 32459561 [PubMed - as supplied by publisher]
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research
In this study, five new evaluators reviewed each other’s readings of the scans, and the researchers rated how well the evaluators agreed with one another’s assessments. Perfect agreement was scored as 1, and no agreement was scored as 0. Agreement was 0.87 across all 241 patients.The most common side effects were headache, pain at the injection site, and increased blood pressure, with all side effects occurring in less than 1.5% of the patients.Flortaucipir F18 was developed by Avid Radiopharmaceuticals Inc., a subsidiary of Eli Lilly and Co. In astatement, Lilly noted that availability of flortaucipir F18 will...
Source: Psychiatr News - Category: Psychiatry Tags: Alzheimer's disease Avid Radiopharmaceuticals cognitive impairment diagnostic Food and Drug Administration imaging protein tau tau neurofibrillary tangles Source Type: research
ABSTRACT A 45-year-old man presents with occipital headache for about one month, resistant to analgesic therapy, and palpable nodule at the pain site. At initial evaluation, the nodule was 1.5 cm in diameter without apparent skin alteration. Ultrasonography revealed a well-defined osteolytic lesion and doubtful communication with the dura mater. The study was complemented with computed tomography and contrast-enhanced magnetic resonance, both identifying lytic lesion with soft tissue component and contrast enhancement, without diffusion restriction, guiding the diagnostic hypothesis of eosinophilic granuloma. Surgical trea...
Source: Jornal Brasileiro de Patologia e Medicina Laboratorial - Category: Pathology Source Type: research
AbstractPurpose of ReviewIntracranial dermoid cysts are benign, rare mass-occupying lesions of the central nervous system arising from the neuroectodermal cell lines. While rupture of intracranial dermoid cysts is rare, it can present with a variety of clinical manifestations. To explore the headache manifestations among patients with ruptured intracranial dermoid cysts. To our knowledge, limited studies focusing on headache due to the intracranial dermoid cysts rupture have been published to date. A literature review was done through PubMed/Medline. Articles within the past 10  years were reviewed. Articles in langua...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
AbstractPurpose of ReviewPrimary headaches are less common and differ in presentation in older versus younger individuals. Secondary headaches become more common among older patients.Recent FindingsDiagnosis and management of headaches in those>  65 years are discussed. Migraine and tension-type headaches are rarely new onset in this age group and should be a diagnosis of exclusion. In older individuals, migraine is more likely to be bilateral with less sensory sensitivities. Migraine aura may present without headache; careful assessment is needed to exclude stroke. Other primary headaches discussed include ...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
AbstractPurpose of ReviewThe purpose of this review is to discuss the current evidence for acupuncture in migraine and to provide insight into which patients may benefit most from acupuncture.Recent FindingsMultiple studies support acupuncture as a validated modality for the prevention of episodic migraine. While small studies on acupuncture for the prevention of chronic migraine are encouraging, evidence for its benefit is limited. Likewise, the existing studies on acupuncture for acute migraine treatment are insufficient.SummaryAcupuncture is commonly used to treat migraine and has gained popularity as a validated non-ph...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
AbstractPurpose of ReviewThe purpose of this review is to summarize the role of avoidance behavior in headache-related disability and overview relevant clinical implications.Recent FindingsAvoidance occupies a central role in contemporary psychological perspectives on headache disorders and other chronic pain conditions. Several cognitive constructs of relevance to headache are influenced and maintained by avoidance behavior. A growing body of literature attests to the notion that avoidance of headache triggers, of stimuli that exacerbate headache, and of broader life domains can negatively affect headache progression, dis...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
ConclusionsMigraine pathophysiology is associated with microstructural abnormalities within the trigeminal nerve that are consistent with histological evidence of altered myelin and/or organization. These peripheral nerve changes may provide further insight into migraine pathophysiology and enable a greater understanding for targeted treatments of pain alleviation.
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
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