Document Detail

Optic nerve sheath diameter is not related to high altitude headache: a randomized controlled trial.
MedLine Citation:
PMID:  22994519     Owner:  NLM     Status:  In-Data-Review    
Abstract Lawley, Justin Stevan, Samuel James Oliver, Paul Mullins, Daniel Morris, Naushad Ali Junglee, Charlotte Jelleyman, and Jamie Hugo Macdonald. Optic nerve sheath diameter is not related to high altitude headache: a randomized controlled trial. High Alt Med Biol. 13:193-199, 2012.-The mechanism of high altitude headache (HAH) remains unknown. The aim of this study was to determine experimentally whether optic nerve sheath diameter (ONSD), as an indicator of intracranial pressure, is related to HAH. Following sea level measurements at 3 and 12 hours (SL), 23 subjects were passively transported to high altitude (3777 m, HA) via cable car. HAH, ONSD, arterial oxygen saturation (Spo(2)), and fluid balance were determined at 3, 12, 24, and 36 hours. After 12 hours exposure to HA, subjects were classified by visual analogue scale (VAS) as either HAH positive (HAH+) or HAH negative (HAH-). Acetazolamide (250 mg) or placebo was then randomly prescribed at 15, 20, and 28 hours. Outcome means were compared via analysis of variance, and relationships between variables were analyzed by longitudinal regression. Acetazolamide had no statistically significant effect on HAH (p=0.63) or ONSD (p=0.98), but produced a negative fluid balance (p<0.01) (and also increased Spo(2) in exploratory analyses). Spo(2) was lower in HAH+ than HAH- [85 (3)% versus 88 (2)%, p=0.03). Nevertheless, ONSD increased similarly in HAH+ and HAH- (interaction p=0.90). ONSD also remained significantly elevated above SL values for the entire HA period [SL, 5.2 (0.5) versus HA, 5.6 (0.5) mm, p<0.01], despite headache resolving with acclimatization [VAS: SL, 1/100 (3) mm versus HA 3 h, 9/100 (13); 12 h, 10/100 (14); 24 h, 8/100 (12); 36 h, 1/100 (4) mm, p<0.01]. Furthermore, HAH was significantly correlated with Spo(2) (β=-1.39, p<0.01) but not with ONSD (β=0.59, p=0.57). These data do not support that intracranial pressure is associated with the development or amelioration of mild HAH. Clinical trial registration NCT01288781.
Justin Stevan Lawley; Samuel James Oliver; Paul Mullins; Daniel Morris; Naushad Ali Junglee; Charlotte Jelleyman; Jamie Hugo Macdonald
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  High altitude medicine & biology     Volume:  13     ISSN:  1557-8682     ISO Abbreviation:  High Alt. Med. Biol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901183     Medline TA:  High Alt Med Biol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  193-9     Citation Subset:  IM; S    
1 Extremes Research Group, School of Sport, Health and Exercise Sciences, Bangor University , Gwynedd, United Kingdom .
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