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There is some evidence that HBOT is effective for termination of acute migraine. NBOT was similarly effective in cluster headache, however with sparse data. Because of costs and poor availability HBOT cannot be regarded as a routine therapy. Further indications in the case of treatment failure using standard therapy need to be defined based on data of future clinical trials.

A case ofgiant cell aortitis causing ascending aortic aneurysm associated with aortic regurgitation is reported. The aneurysm was excised and the aortic valve replaced using afresh homograft. The patient has beenfollowed upfor three and a halfyears. There is good evidence of correction of the haemodynamic lesion and no evidence of further arteritis or aneurysmal formation. The pathological and clinical problems of this disease are discussed.Giant cell aortitis is a rare cause of aortic aneurysm. Histological features are similar to those encountered in temporal arteritis and consist of medial inflammatory changes with destruction of the muscular and elastic fibres of the aortic wall. A striking feature of the inflammatory infiltrate is the presence of multinucleate giant cells, usually of Langhans type.Since it may not be clinically evident, the diagnosis of giant cell aortitis is often first made by the histopathologist after necropsy or operation.The purpose of this paper is to describe a patient with giant cell aortitis, with resultant ascending aortic aneurysm and aortic regurgitation treated by excision of the aneurysm and homograft replacement of the aortic valve with reimplantation of the coronary ostia into the Dacron graft. The clinical and pathological features of this disease are discussed. Case reportA 61-year-old man was admitted to Harefield Hospital because of increasing dyspnoea and an aortic murmur. There was no family history of heart disease. The patient was well until 1970 when he began to hear noises in the ears which were synchronous with the pulse. Since then he had been increasingly conscious of fatigue and thought he was slightly short of breath, especially on stooping. He had no polymyalgia, headache, or chest pain. In 1972, on a routine medical examination, a heart murmur was heard. There was no history of rheumatic fever or venereal disease. He was known to have had a peptic ulcer which gave rise to occasional bleeding.On examination the jugular pressure was normal, the pulse regular at a rate of 82 a minute and of collapsing type. All pulses were palpable, with prominent carotid pulsations in the neck. The blood pressure was 160/60 mmHg. There was left ventricular enlargement grade 3/4. Both heart sounds were present, and in the aortic area an ejection systolic murmur grade 2/4 and an early diastolic murmur grade 2/4 were heard. Physical examination otherwise showed no abnormalities.Laboratory tests showed negative serology for syphilis. The ESR was 4 mm (Westergren

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