What are sinus and vascular headaches ?
Sinus" headaches
Acute sinus infections may present with pain behind an eye, over the eyebrows or in the upper cheek and teeth. These symptoms may become much more intense when descending rapidly from altitude. Some people have described the intensity as like an ice pick driven through the face. These obviously incapacitating sinus headaches are relieved over time with decongestants, antibiotics and acclimatization to altitude, as well as pain medication. Chronic sinus headaches are not as intense, but require the same treatment to resolve.Migraines and vascular headaches
In the United States, 4% of women and 1% of men suffer true migraine headaches each year. Nationwide, 12-16 million people suffer from migraine headaches each year. The term "migraine headache" is often used by lay persons to describe a rather severe headache from any cause. This terminology is not accurate and pilots/controllers should be particularly careful in using this term, as it may adversely effect medical certification. True "migraines" may occur without any head pain whatsoever, as noted below.Migraine headaches are defined as recurrent, benign headaches with or without neurologic symptoms. They are frequently triggered by specific stimuli, such as foods, alcohol, flashing lights, lack of sleep and many others. A key element in the definition is "recurrent". A single typical headache can not be characterized as a migraine unless it recurs. The inclusion of the term "benign" in the definition does not imply that migraines are not severe or incapacitating, but indicates there is no associated medical condition that will progress if left untreated.
"Migraine" headaches are also termed "vascular" headaches because the proposed mechanism of the symptoms is spasm and dilation of the blood vessels (vascular) to the brain and its surface. The muscles of the scalp and neck are not directly involved as they are with tension headaches. Treatments to both relieve and prevent of migraine/vascular headaches are designed to alleviate the vascular spasm.Several types of migraines exist. They are classified by the character of the symptoms. Depending on the symptoms and the frequency, migraine headaches may or may not be disqualifying for flying. The type of treatment and its success is also a major determinant in whether a pilot is authorized to fly with this condition.
