Headache attributed to airplane travel

Headache attributed to airplane travel, also named ‘airplane headache’ (AH) is a recently described clinical entity characterized by the sudden onset of a severe head pain, which appears exclusively in relation to airplane flights, mainly during the landing phase. Secondary causes, such as upper respiratory tract infections or acute sinusitis, must be ruled out. Although its pathophysiology is not completely understood, a causative role is attributed to an imbalance of the intrasinus pressure, consequent to a change of external air pressure not paralleled with an adequate compensation inside the cranial sinuses. In the International Classification of Headache Disorders, second edition (ICHD-2) AH is not mentioned. On the basis of an extended investigation, AH diagnostic criteria were proposed, which have been introduced for the first time in the recently published ICHD-3B version. Its formal recognition will favour further studies aimed at improving knowledge about AH and implementing preventative measures.