High Altitude Headache

Río, Margarita Sánchez del; Moskowitz, Michael A.

doi:10.1007/978-1-4615-4711-2_13

Cited by 62 publications

(7 citation statements)

References 22 publications

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“…These include alteration of the blood-brain barrier by endothelial growth factor, nitric oxide, and bradykinin, and activation of the trigeminovascular system by both chemical and mechanical stimulation. We note that the hypothesis of Sanches del Rio and Moskowitz 25 is similar to that for the production of migraine headache discussed earlier.…”

Section: Cervicogenic Headachesupporting

confidence: 80%

Migraine Headache Confounding the Diagnosis of Acute Mountain Sickness

Karle

Auerbach

2014

Wilderness & Environmental Medicine

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A 36-year-old man with a history of migraine headache attempted to hike from Lukla, Nepal, to Mount Everest Base Camp. On the sixth day of hiking, he had a migraine headache. After achieving resolution with typical therapies and rest, he ascended higher. Another headache developed that was interpreted to be a migraine. The headache was treated, and he ascended higher, after which severe symptoms of acute mountain sickness developed, necessitating his evacuation by helicopter. Persons with headaches in daily life may present challenges to diagnosis when traveling to high altitude. Careful evaluation and decision making are needed to achieve proper diagnosis and treatment of acute mountain sickness.

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Section: Cervicogenic Headachesupporting

confidence: 80%

Migraine Headache Confounding the Diagnosis of Acute Mountain Sickness

Karle

Auerbach

2014

Wilderness & Environmental Medicine

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“…First, Sanchez del Rio et al . [29] found that nitric oxide (NO) can irritate and discharge the nerve fibers constituting the trigeminovascular system, resulting in high-altitude headaches. Moreover, NO increases blood-brain barrier permeability, which may also cause headaches [30].…”

Section: Discussionmentioning

confidence: 99%

Association between smoking and the risk of acute mountain sickness: a meta-analysis of observational studies

Wang

et al. 2016

Military Med Res

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BackgroundPeople rapidly ascending to high altitudes (>2500 m) may suffer from acute mountain sickness (AMS). The association between smoking and AMS risk remains unclear. Therefore, we performed a meta-analysis to evaluate the association between smoking and AMS risk.MethodsThe association between smoking and AMS risk was determined according to predefined criteria established by our team. Meta-analysis was conducted according to the PRISMA guidelines. We included all relevant studies listed in the PubMed and Embase databases as of September 2015 in this meta-analysis and performed systemic searches using the terms “smoking”, “acute mountain sickness” and “risk factor”. The included studies were required to provide clear explanations regarding their definitions of smoking, the final altitudes reached by their participants and the diagnostic criteria used to diagnose AMS. Odds ratios (ORs) were used to evaluate the association between smoking and AMS risk across the studies, and the Q statistic was used to test OR heterogeneity, which was considered significant when P < 0.05. We also computed 95% confidence intervals (CIs). Data extracted from the articles were analyzed with Review Manager 5.3 (Cochrane Collaboration, Oxford, UK).ResultsWe used seven case-control studies including 694 smoking patients and 1986 non-smoking controls to analyze the association between smoking and AMS risk. We observed a significant association between AMS and smoking (OR = 0.71, 95% CI 0.52–0.96, P = 0.03).ConclusionsWe determined that smoking may protect against AMS development. However, we do not advise smoking to prevent AMS. More studies are necessary to confirm the role of smoking in AMS risk.

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“…How a small fluid shift might cause a rise in AMS symptom severity is not known. Hansen and Evans (10) hypothesized that a change in intracranial dynamics secondary to a small increase in intracranial fluid could cause distortion or compression of painsensitive regions in the brain (3). Compression of the corpus collossum recently has been documented in the brains of patients with high-altitude cerebral edema (9), a syndrome considered by most to be a rare, late-stage form of AMS.…”

Section: Discussionmentioning

confidence: 99%

Exercise exacerbates acute mountain sickness at simulated high altitude

Roach

Maes

Sandoval

et al. 2000

Journal of Applied Physiology

202

102

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We hypothesized that exercise would cause greater severity and incidence of acute mountain sickness (AMS) in the early hours of exposure to altitude. After passive ascent to simulated high altitude in a decompression chamber [barometric pressure = 429 Torr, approximately 4,800 m (J. B. West, J. Appl. Physiol. 81: 1850-1854, 1996)], seven men exercised (Ex) at 50% of their altitude-specific maximal workload four times for 30 min in the first 6 h of a 10-h exposure. On another day they completed the same protocol but were sedentary (Sed). Measurements included an AMS symptom score, resting minute ventilation (VE), pulmonary function, arterial oxygen saturation (Sa(O(2))), fluid input, and urine volume. Symptoms of AMS were worse in Ex than Sed, with peak AMS scores of 4.4 +/- 1.0 and 1.3 +/- 0.4 in Ex and Sed, respectively (P < 0.01); but resting VE and Sa(O(2)) were not different between trials. However, Sa(O(2)) during the exercise bouts in Ex was at 76.3 +/- 1.7%, lower than during either Sed or at rest in Ex (81.4 +/- 1.8 and 82.2 +/- 2.6%, respectively, P < 0.01). Fluid intake-urine volume shifted to slightly positive values in Ex at 3-6 h (P = 0.06). The mechanism(s) responsible for the rise in severity and incidence of AMS in Ex may be sought in the observed exercise-induced exaggeration of arterial hypoxemia, in the minor fluid shift, or in a combination of these factors.

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High Altitude Headache

Cited by 62 publications

References 22 publications

Migraine Headache Confounding the Diagnosis of Acute Mountain Sickness

Migraine Headache Confounding the Diagnosis of Acute Mountain Sickness

Association between smoking and the risk of acute mountain sickness: a meta-analysis of observational studies

Exercise exacerbates acute mountain sickness at simulated high altitude

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