What are the other Names for this Condition? (Also known as/Synonyms)

• Headache from Diving

What is Diving Headache? (Definition/Background Information)

• Diving Headache is a headache disorder that occurs secondary to diving to depths over 10 meters; the headache that develops during the dive, increases in intensity during/upon resurfacing owing to elevated carbon dioxide levels in the bloodstream (or hypercapnia). However, an absence of decompression sickness, caused by nitrogen buildup in the blood and tissues, is important for establishing a diagnosis
• The cause of Diving Headache, which occurs from intracranial vasodilatation and increased cerebrospinal fluid pressure, may be due to:
  • Unintentional hypoventilation from tight wetsuits that restrict breathing (chest wall expansion)
  • Increased physical exertion from diving causing inadequate ventilation
  • Practicing skip breathing (intermittently holding one’s breath) under the mistaken notion of conserving air
  • Minimizing buoyancy while navigating narrow passages or underwater cave diving through shallow breathing techniques
• Besides headache that increases in severity, the affected divers may present dizziness, labored breathing, confusion, physical coordination issues, and flushing of the face. The headache and other symptoms are known to improve and regress within 60 minutes on immediate treatment with oxygen, or spontaneously after 3 days

The criteria for diagnosis of Diving Headache as outlined by the International Headache Society (IHS) is given below:

• Both of the following:
  • The patient is diving at a depth over 10 meters
  • No evidence of decompression illness
• Any headache fulfilling the criterion below

Evidence of causation demonstrated by at least one of the following:

• Headache has developed during the dive
• Either or both of the following:
  • Headache has worsened as the dive is continued
  • Headache has spontaneously resolved within 3 days of completion of the dive OR, headache has remitted within 1 hour after treatment with 100% oxygen
• At least one of the following symptoms of CO2 intoxication:
  • Mental confusion
  • Light-headedness
  • Motor incoordination
  • Dyspnea
  • Facial flushing

Not better accounted for by another ICHD-3 diagnosis.

(Source: International Headache Society Classification ICHD-3, London, United Kingdom)