Characteristics of Headache at Altitude among Trekkers; A comparison between Acute Mountain Sickness and Non-Acute Mountain Sickness Headache

Abstract

Purpose: Headache at altitudes has had an incidence of 25-62% through many related studies. Many reasons are identified concerning headache at altitudes such as acute mountain sickness (AMS), sinus headache, migraine, tension type headache, and frontal tension headache. This study tried to compare different types of headache among trekkers on Mount Damavand, a 5671m mountain, Iran, to find their incidence and related symptoms and signs.Methods: Through a cross-sectional study, we evaluated headache incidence and its correlation to AMS among people who climbed Mount Damavand. Lake Louise Score, a self-report questionnaire, was applied to make AMS diagnosis through three separate stages of trekking programs. Chi-square test was employed as the main mean of analysis.Results: Totally, 459 between 13-71 year olds participated in the study among which females were 148 (32.1%) and males 311 (67.8%). Headache was found in 398 (86.7%) among whom 279 (70%) were proved as AMS. Investigating the types of headache in the cases of AMS showed 64.5% to be of steady, 31% throbbing and 4.5% stabbing characters which had significant differences with a P value = 0.003. The majority of headaches were stated as frontal (38.9%) and the least prevalence belonged to the parietal area (4.4%), while global headache was reported in 27%.

Hemodynamic characteristics of high-altitude headache following acute high altitude exposure at 3700 m in young Chinese men

“…HAH is a regional symptom that comprises the primary diagnostic criteria of acute mountain sickness, which is typically induced by a local and systematic factor [ 5 , 24 ]. Therefore, systemic hemodynamics may be a cause of HAH because it functions to deliver blood to all organs, including the brain, which is an organ with considerably high metabolism and energy consumption.…”

“…A reduced SpO 2 and increased HR are independent risk factors for HAH [ 8 , 9 ]. These changes could result from sympathetic nervous system activation and a decreased partial pressure of oxygen, which results in a decrease in oxygen delivery to the brain, where oxygen consumption is increased during hypoxic stress [ 5 , 9 , 6 ]. The change in tricuspid regurgitation in HAH patients differed from the non-HAH subjects, which indicates alterations in cardiac function induced by hypoxia may be risk factors for HAH (see Additional file 1 ).…”

“…Over the past several decades, epidemiology, clinical characteristics, risk factors, prevention and treatment aspects of HAH have been systematically studied in mountaineers [ 5 , 2 , 6 , 7 ]. Clinical characteristics studies have showed that HAH presents as a sudden attack of migraine that is accompanied by nausea [ 6 ].…”

“…While most previous studies have focused on the risk factors and epidemiology of HAH, few of them give proper attentions to the hemodynamic characteristics of HAH [ 8 , 9 , 7 ]. Furthermore, most of these studies have been conducted in mountaineers, which may not reflect representative properties of HAH [ 5 , 9 , 12 ].…”

Risk factors for high-altitude headache upon acute high-altitude exposure at 3700 m in young Chinese men: a cohort study

“…Smoking and alcohol consumption were classified as follows: 0 = no smoking/drinking history, 1 = past smoking/drinking history, and 2 = present smoking/drinking (smoking and drinking regularly). Headache (AMS-headache) and other symptoms in relation with AMS such as dizzy, insomnia, gastrointestinal symptoms and fatigue were included in the CRFs [15]. The HAH relies on the patient-reported headache in the CRFs which have been interpreted by the physicians.…”