Airplane headache: a scoping review of mechanisms and reported therapeutic strategies.

INTRODUCTION: Airplane headache (AH) is a headache disorder recognized in the International Classification of Headache Disorders, 3rd edition (ICHD-3) and characterized by severe, short-lasting, fronto-orbital pain occurring during aircraft take-off or, more typically, landing. Despite growing clinical recognition, evidence regarding its epidemiology, pathophysiology and management remains fragmented across heterogeneous studies. AREAS COVERED: This scoping review maps the current literature on AH based on structured searches in PubMed and Embase from inception to 30 April 2026. Thirty-three studies were included, collectively involving several hundred patients, predominantly case reports and small case series, with a small number of cross-sectional surveys and a single experimental study using a hypobaric chamber model. Findings were organized thematically. EXPERT OPINION: AH is best conceptualized as a disorder where a stereotyped barometric stimulus triggers a predisposed trigeminovascular system, although this interpretation remains speculative. Whether current diagnostic criteria are overly restrictive remains an open question and warrants formal validation. Therapeutic strategies, meanwhile, rely entirely on uncontrolled data. Randomized cross-over trials and mechanistic interpretation studies represent the most pressing priorities for future research.