Abstract
This review will focus on the most recent information regarding the ICHD-3 definition of diving headache as well as other important causes of diving headache that are not listed in the ICHD-3 classification system. The paper will discuss etiology, diagnosis, and management of these disorders, focusing, when possible, on the newest research available. ICHD-3 diving headache is due to hypercapnia and is treated accordingly with oxygen. Other causes of diving headache range from decompression sickness to external compression headache to primary headache disorders, such as migraine. Correctly determining the underlying cause of the diving headache is critical to management and relies on history taking and physical exam. The pathophysiology of newly described types of diving headache, such as diving ascent headache, remains under investigation but may be related to other homeostatic headache causes, such as airplane headache. Further investigation may yield more information regarding management as well as possible insight into other headache disorders.
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Change history
10 August 2019
The original version of this article incorrectly listed the second author’s name. It should be Stephanie J. Nahas, not Stephanie J. Nahas-Geiger. The author name is corrected in this erratum.
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Fabio RD, Vanacore N, Davassi C, Serrao M, Pierelli F. Scuba diving is not associated with high prevalence of headache: a cross-sectional study in men. J Headache Pain. 2011;52:385–92.
Cheshire WP, Ott MC. Headache in divers. J Headache Pain. 2001;41:235–47.
Arngrim N, Schytz HW, Britze J, et al. Migraine induced by hypoxia: an MRI spectroscopy and angiography study. Brain. 2015;139:723–37.
• Grewal P, Smith JH. When headache warns of homeostatic threat: the metabolic headaches. Curr Neurol Neurosci Rep. 2017;17. https://doi.org/10.1007/s11910-017-0714-5. Good recent overall review of homeostatic headache disorders.
Vein A, Koppen H, Haan J, Terwindt G, Ferrari M. Space headache: a new secondary headache. Cephalalgia. 2009;29:683–6.
Akyol A. Giant Virchow- Robin spaces may play a role at headache attributed to hypoxia and/or hypercapnia. Agri. 2018. https://doi.org/10.5505/agri.2018.98360.
Schipke JD, Cleveland S, Drees M. Sphenoid sinus barotrauma in diving: case series and review of the literature. Curr Pain Headache Rep. 2017;26:124–37.
Cheshire WP. Headache and facial pain in scuba divers. Curr Pain Headache Rep. 2004;8:315–20.
Newton HB. Neurologic complications of scuba diving. Am Fam Physician. 2001;63:2211–8.
Walters GK. Cervicocranial artery dissection and scuba diving: is there a link or is it serendipity? Undersea Hyperb Med. 2018;45:65–73.
•• Mainardi F, Maggioni F, Zanchin G. Aeroplane headache, mountain descent headache, diving ascent headache.. Three subtypes of headache attributed to imbalance between intrasinusal and external air pressure? Cephalalgia. 2017;38:1119–27. Paper discussing the significance of airplane headache and possible correlation with diving ascent headache.
Mcdermott JH, Reynard C, Perry J, Dear JW, Child F, Jenner R. Acute carbon monoxide toxicity in a paediatric cohort: analysis of 10 boys poisoned during a scuba diving lesson. Clin Toxicol. 2018;56:856–9.
Rosińska J, Łukasik M, Kozubski W. Neurological complications of underwater diving. Neurol Neurochir Pol. 2015;49:45–51.
Tetzlaff K, Shank ES, Muth CM. Evaluation and management of decompression illness—an intensivist’s perspective. Intensive Care Med. 2003;29:2128–36.
Livingstone DM, Smith KA, Lange B. Scuba diving and otology: a systematic review with recommendations on diagnosis, treatment and post operative care. Diving Hyperb Med. 2017;47:97–109.
Livingstone D, Lange B. Rhinologic and oral-maxillofacial complications from scuba diving: a systematic review with recommendations. Diving Hyperb Med. 2018;48:79–83.
Ipekdal HI, Karadaş Ö, Öz O, Ulaş ÜH. Can triptans safely be used for airplane headache? Neurol Sci. 2011;32:1165–9.
Volta GD, Guindani M, Zavarise P, Griffini S, Pezzini A, Padovani A. Prevalence of patent foramen ovale in a large series of patients with migraine with aura, migraine without aura and cluster headache, and relationship with clinical phenotype. J Headache Pain. 2005;6:328–30.
Germonpre P, Balestra C. Risk of decompression illness among 230 divers in relation to the presence and size of patent foramen ovale. Eur Heart J. 2004;25:2173–4.
•• Smart D, Mitchell S, Wilmshurst P, Turner M, Banham N. Joint position statement on persistent foramen ovale (PFO) and diving. South Pacific Underwater Medicine Society (SPUMS) and the United Kingdom Sports Diving Medical Committee (UKSDMC). Diving Hyperb Med. 2015;45:129–31. Guidelines from diving medicine societies regarding PFO screening and management in divers.
Bui SBD, Gazerani P. Headache attributed to airplane travel: diagnosis, pathophysiology, and treatment – a systematic review. J Headache Pain. 2017;18. https://doi.org/10.1186/s10194-017-0788-0.
Bui SBD, Petersen T, Poulsen JN, Gazerani P. Simulated airplane headache: a proxy towards identification of underlying mechanisms. J Headache Pain. 2017;18. https://doi.org/10.1186/s10194-017-0724-3.
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Burkett, J.G., Nahas-Geiger, S.J. Diving Headache. Curr Pain Headache Rep 23, 46 (2019). https://doi.org/10.1007/s11916-019-0787-8
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DOI: https://doi.org/10.1007/s11916-019-0787-8