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We read with great interest the expert opinion commenting on airplane descent headaches recently published in this journal.1 As the authors said, this clinical presentation contrasts with the description done by Adkinson and Lee2 and others where the headache is present either during airplane take off and landing, or both. It was noteworthy for us that after more than 20 years of investigating several neurological problems in Colombia using the World Health Organization neuroepidemiological instrument for developing countries we have not detected a single case of it.3-5 Likewise, there are no prevalence values on this medical problem, to date, in the world. We hypothesized that it could be due to the transient and specific place of presentation of this headache, namely, at airplanes. To solve this situation, we have started a large neuroepidemiological study in Colombia, South America, looking for the prevalence of this medical problem, there taking the advantage of having one of the few 3-year aerospace medicine residency programs existing in the world for civilian and military medical doctors.

With the aforementioned comments, we defined for our study probable subtypes of airplane headaches as follows:6“aeroheadache type I” as the headache displaying clinical symptoms, clinical course, presentation, and outcome as described by Atkinson and Lee and fulfilling the criteria defined recently by Mainardi et al,2,7,8 and “aeroheadache type II,” the one commented by Evans et al,1 indeed the headache present only while airplanes descend. Should new subtypes of airplane headaches appear, we suggest naming them as type III, and so on.

We hope this headache clinical subclassification proposal may be useful not only to do epidemiological studies in Colombia but elsewhere and, also, to gain more knowledge on the pathophysiology and further approach of these “modern” headaches.

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