ABSTRACT
Headache is one of the more common neurological symptoms presenting to the practitioner of aviation medicine, and correct diagnosis and management are crucial to the livelihood and welfare of aircrew, as well as the safety of others. Migraine and tension-type headache are likely to be the most frequent reasons for referral to the aeromedical practitioner. Classical migraine may be preceded by a prodrome occurring up to a day before the onset of headache, in which the observant patient may be aware of a change in mood, often reporting feeling uncommonly well with increased appetite. The headache is typically pulsating and unilateral, and characteristically contralateral to the preceding sensory aura. The patient who misses breakfast often develops migraine mid-morning, while the busy office worker who misses lunch may develop a headache in the mid-afternoon. The cause of migraine remains unknown. It is not thought to be simply ‘vascular’ in aetiology.
