Travel Reference
In-Depth Information
acheafterarapidascenttoaltitudeiscommonandisusuallyasymptomofacutemountain
sickness ( Chapter 24: Disorders Caused by Altitude ). Headache can also be caused by de-
hydration.
The pain of a headache may be located in the back of the neck, behind the eyes, or all
areasinbetween.Littlesignificancecanbeattachedtothelocationofthepainexceptwhen
it is limited to one side of the head, which is typically a sign of vascular headaches (mi-
graine).
A severe, persistent headache in an individual who usually does not suffer from head-
aches may be a sign of serious disease. Headache associated with confusion, forgetfulness,
dizziness, nausea and vomiting, and (rarely) convulsions or loss of consciousness may be
the result of an acute increase in blood pressure (hypertensive encephalopathy). This dis-
order usually occurs in persons with preexisting hypertension and requires prompt treat-
ment ( Chapter 17: Heart and Blood Vessel Disorders ) . Headache associated with fever and
a stiff neck are characteristic of meningitis. Following a head injury, increasing severity of
a headache may be indicative of the development of a blood clot within the skull ( Chapter
8:HeadandNeckInjuries ) .Acetaminophen,ibuprofen,oraspirineverythreetofourhours
relieves the pain of most headaches; acetaminophen and codeine or aspirin and codeine
takenwiththesamefrequencyareadequateformostoftheremainder.Individualswithfre-
quent headaches should consult a physician. Some causes of recurrent headaches, such as
brain tumors or high blood pressure, are quite serious but usually come on so slowly they
would cause problems in the wilderness only on a protracted expedition. However, a few
individuals with brain tumors have first experienced symptoms when they developed high-
altitude cerebral edema ( Chapter 24: Disorders Caused by Altitude ) .
Fainting (Syncope)
Fainting is a common disorder that usually is not a sign of organic disease. It typically
follows emotional stress and sometimes occurs without an identifiable cause. When faint-
ing is the result of disease, the disorder most often involves the heart and not the nervous
system. Therefore, this condition is discussed in Chapter 17: Heart and Blood Vessel
Disorders . It can also be the result of low blood pressure and is discussed in Chapter 3:
Life-Threatening Problems .
Bell's Palsy
Bell's palsy is the most common form of facial paralysis and involves the muscles in-
nervated by the seventh cranial nerve. The paralysis develops rapidly and maximum weak-
ness is present within twentyfour to forty-eight hours. The condition is painless, and in its
early stages the individual may have to be told that it is present. No etiology can be identi-
fied for most individuals, although persons with untreated Lyme disease may develop this
type of paralysis. The prognosis is good; about 80 percent of individuals with this condi-
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