-The purpose of this study was to assess the prevalence and frequency of the headaches in Brazilian schoolchildren. A cross-sectional study was conducted between March and November 2004 in São José do Rio Preto, São Paulo State, Brazil. A sample of 5,232 children from elementary schools was selected using proportional stratified sampling method. To collect data, a questionnaire was handed out in the schools to the schoolchildren to be answered by parents or guardians. From the total answers received, 84.2% reported headache complaints during the last year. There were significant complaint differences between males and females. Females were reported as having more frequent headaches than males with daily ones occurring twice as many times. A greater headache frequency was also reported for increasing age. The study has shown that headache prevalence was high, with a predominantly higher frequency (monthly, weekly and daily) with girls and older age groups.KEY WORDS: headache, prevalence, schoolchildren. Um estudo epidemiológico de cefaléias em escolares brasileiros, com foco sobre a frequência da dorResumo -O objetivo deste estudo foi avaliar a prevalência e frequência de cefaléia em escolares brasileiros. Um estudo transversal foi conduzido entre Março e Novembro de 2004 em São José do Rio Preto, Estado de São Paulo, Brasil. Uma amostra de 5.232 crianças das escolas foi selecionada utilizando método de amostragem estratificada proporcional. Para a coleta dos dados, um questionário foi entregue nas escolas aos estudantes para ser respondida pelos pais e/ou responsáveis. Do total de respostas recebidas, 84,2% relataram cefaléia durante o último ano. Houve diferenças significativas na frequência da queixa de cefaléia entre meninos e meninas. As meninas relataram cefaléias mais frequentes do que os meninos, com prevalência de cefaléias diárias duas vezes maior em meninas. Uma maior frequência de cefaléia foi também relatada com o aumento da idade. O estudo demonstrou que a prevalência de cefaléia foi alta, com uma maior frequência (mensais, semanais e diárias) em meninas e no grupo etário mais velho. PALAVRAS-CHAVE: cefaléia, prevalência, escolares. Headaches are one of the most common symptoms during childhood and are one of the main complaints in consulting rooms. In many cases the headaches are long lasting and frequent enough to warrant special care.Since the classic study by Bille 1 , in Sweden, in 1962, several epidemiological studies were undertaken worldwide using the most different types of methodology. These studies suggested a high prevalence of headaches among children and adolescents at varying rates of 20% 2 at the age of 5 and up to 97% in older children and adolescents [3][4][5][6][7][8][9][10][11] . This wide range in the estimate prevalence from several studies results from a number of factors, among which are methodological procedures and age group of the studied population. In one of the few studies done on a Brazilian population, Barea et al.12 evaluated 538 students between the ages of...

ContribuiÇÃo da SeQÜÊnCia difuSÃo da Mr no diagnÓStiCo e aCoMpanhaMento da enCefalopatia por doenÇa da urina eMMaple syrup urine disease (MSUD) or leucinosis is caused by a deficiency of the catalytic components of the α-ketoacid-dehydrogenase complex, which is responsible for the catabolism of branched-chain amino acids (leucine, isoleucine, and valine) 1,2 . It is an inherited genetic disease with an autosomal recessive pattern affecting approximately 1 out of 120,000-500,000 infants worldwide 3,4 . Diagnosis is made clinically based on the peculiar maple syrup odor or sugar burnt of the urine, encephalopathy, increased levels of branched-chain amino acids in the plasma and urine, and the presence of α-hydroxyacid and branched-chain α-ketoacids in urine. The presence of plasma L-alloisoleucine and urinary α-hydroxyisovalerate are pathognomonic for MSUD 2 . According to the literature, five forms of MSUD have been described: classic, intermediate, intermittent, thiamine-responsive, and dihydrolipoyl dehydrogenase-deficient. The commonest and severest form of the disease is the classic type, which is characterized by a neonatal onset of encephalopathy 2 . Magnetic resonance imaging (MRI) studies in the acute phase of classic MSUD are characterized by diffuse edema corresponding to both myelinated and unmyelinated areas of the brain [3][4][5][6] . The purpose of this case report is to show conventional MRI and diffusion-weighted imaging (DWI) findings of the different evolutionary phases in MSUD of a newborn that evolved with brain white matter lesions. CaSeA full-term male infant born from an uneventful pregnancy and delivery, with a birth weight of 3.245g and Apgar scores of 9/10 (at 1 and 5 min, respectively), was hospitalized because of sucking difficulties, weak cry, and lethargy. At 10 days of life, the baby had episodes of seizures, bradycardia, and apnea, leading to coma. Biochemical examinations showed hypoglycemia and metabolic ketoacidosis. Brain MRI at 10 days of life showed hypersignal lesions on DWI and corresponding hyposignals on ADC maps throughout the white matter of the brainstem, cerebella and internal capsules (Fig 1).At 20 days of life the clinical condition of the baby became critical and maple syrup odor or sugar burnt was noted in the urine. A repeat MRI at this time showed increasing myelinating white matter lesions and new hypersignal lesions on T2-weighted sequences and hyposignal on the diffusion-weighted images located in the unmyelinated white matter of the frontal, parietal and temporal lobes (Fig 2).At 25 At 8 months of age, a follow-up MRI was performed that showed persisting white matter lesions in the frontal, parietal and temporal lobes with associated hypersignal on DWI and hy-