Two reports of flight-related headache

Area of Science:

• Neurology
• Otolaryngology

Background:

• Airplane headache is a flight-associated cephalalgia occurring during air travel.
• Its exact cause remains unclear, with sinus barotrauma proposed as a potential mechanism.

Observation:

• Case 1: A young woman experienced severe orbital and temporal pain during airplane descent, responding to nasal decongestants.
• Case 2: A man reported forehead pain during landings, linked to stress and sleep deprivation, with no response to NSAIDs.

Findings:

• Computed tomography (CT) scans revealed no abnormalities in either case, except for nasal mucosa thickening in Case 1.
• Sinus barotrauma is a plausible cause for Case 1, while anxiety may underlie Case 2.

Implications:

• The etiology of airplane headaches is likely multifactorial.
• Clinicians should consider diverse causes when evaluating in-flight headaches.