Introduction: Ingesting some foods can trigger headache attacks in migraine patients. Diet-sourced citrulline activates the L-arginine-nitric oxide pathway, acting on the pathophysiology of migraine. Objectives: To characterize the ingestion of watermelon (Citrullus lanatus) as an activating factor of the L-arginine-nitric oxide pathway and as a trigger for headache attacks in patients with migraine. Subjects and Methods: The study was a clinical trial, interventional, controlled and with group comparison. The sample was non-random, composed of 38 volunteers with migraine and 38 without headache (control). Both groups ingested a portion of watermelon to determine the onset of headache attacks. Before and after ingesting watermelon, they underwent blood collections to determine serum nitrite levels. Results: There were 38 volunteers diagnosed with migraine without aura and 38 controls, whose mean age was, respectively, 22.4±1.5 and 22.9±3.1 years (p=0.791). Headache was triggered by watermelon ingestion after 124.3±20.5 min of ingestion in 23.7% (9/38) of the migraine volunteers and in none of the controls (p=0.002). There was an increase in serum nitrite levels, both in migraine volunteers (23.4%) and in the control group (24.3%) after watermelon ingestion. This difference was significant (p<0.001). Conclusions: Watermelon ingestion triggered headache attacks in migraine patients and increased serum nitrite levels, attesting a possible activation of the L-arginine-nitric oxide pathway.

OBJETIVO Descrever as caracter ısticas cl ınicas e as melhores opc ßões terapêuticas para cefaleia em salvas na idade pedi atrica.M ETODO Com base em pesquisa bibliogr afica nas bases de dados m edicos PubMed, LiLacs e WoS e usando descritores selecionados, analisamos todos os relatos de casos de cefaleia em salvas em idade pedi atrica publicados de 1990 a 2020.RESULTADOS Cinquenta e um pacientes (29 meninos e 22 meninas) com idade m edia (DP) de 9 anos e 7 meses (3 anos e 10 meses), variando de 2 a 16 anos, foram diagnosticados com cefaleia em salvas. O diagn ostico m edio (DP) foi feito 27,8 meses (26,2 meses) ap os o in ıcio da cefaleia em salvas. A dor ocorreu a noite ou ao despertar (76,5%), uma a três crises por dia (62,7%), com durac ßão de 30-120 minutos (68,6%), localizada unilateralmente (90,2%), de car ater puls atil (64,7%) e intensidade severa (100%). Houve manifestac ßões autonômicas (90,2%), predominantemente ipsilaterais a dor, nesta ordem: lacrimejamento, injec ßão conjuntival, congestão nasal, ptose, edema palpebral e rinorreia. Sumatriptano e inalac ßão de oxigênio foram os tratamentos agudos mais eficazes. Na profilaxia, corticosteroides, verapamil e gabapentina foram os medicamentos mais eficazes.