High-altitude headache: a narrative review
Andrea Veronica Marengo1,2, Malena Tejada3, María Isabel Cusicanqui Giles4,5, Katherine Natali Ramirez Andia6
1Department of Neurology, Hospital Perrupato, San Martín, Mendoza, Argentina. 2Chair of Neurology, Faculty of Medicine, National University of Cuyo, Mendoza, Argentina 3Critical Care Unit, Hospital Santa Caterina, Girona, Spain 4Department of Neurology, Hospital de Clínicas, La Paz, Bolivia 5Faculty Member, Universidad Mayor de San Andrés, La Paz, Bolivia 6Neurologist, University Hospital of Clínicas, La Paz, Bolivia
Purpose of review
This narrative review aims to summarize current evidence on the epidemiology, pathophysiological mechanisms, risk factors, differential diagnosis, and preventive and therapeutic strategies of High-altitude headache (HAH) to raise awareness among physicians.
Recent findings
HAH is the most common neurological symptom associated with acute mountain sickness (AMS) and has become a global health concern due to the increasing exposure to high altitudes through tourism, sports and work. Its pathophysiology is complex and multifactorial, involving hypobaric hypoxia, blood–brain barrier dysfunction, and trigeminovascular system activation.
Conclusions
The diagnostic criteria of the ICHD-3 and the Lake Louise Score are highlighted as essential clinical tools, especially regarding moment of evacuation. Knowledge gaps were identified in areas such as biomarkers, updated epidemiological data, diagnostic standardization and vulnerable populations. Improving understanding and management of HAH is critical as global exposure to high-altitude environments continues to rise.