Headache as an Emergency in Children and Adolescents

Papetti, Laura; Capuano, Alessandro; Tarantino, Samuela; Vigevano, Federico; Valeriani, Massimiliano

doi:10.1007/s11916-015-0480-5

Cited by 22 publications

(20 citation statements)

References 33 publications

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“…Besides, prevalence of headache peaked during adolescence. As shown in previous studies, headache prevalence among childhood or adolescence varied widely, from 5.9 to 82%, bringing high costs to individual and society [17][18][19] . It presented a gradual upward trend throughout childhood, peaking at about 11 to 13 years old [17][18] .…”

Section: Resultsmentioning

confidence: 65%

“…As shown in previous studies, headache prevalence among childhood or adolescence varied widely, from 5.9 to 82%, bringing high costs to individual and society [17][18][19] . It presented a gradual upward trend throughout childhood, peaking at about 11 to 13 years old [17][18] . And headache in children or adolescents can result in impaired psychosocial function, as a major factor associated with school absenteeism and poorer quality of life 18 .…”

Section: Resultsmentioning

confidence: 65%

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An Overall Trend of Headache Remission during COVID-19 Pandemic for Chinese Patients with Pre-existing Headache Highlights the Role of Family Supports

Gong

Liu

et al. 2020

Preprint

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Background: Impact of COVID-19 pandemic on Chinese patients with pre-existing headache remains unclear. The present study investigated the impact of COVID-19 pandemic on headache patients in China.Methods: A survey was conducted through an online survey platform from June 6, 2020. Demographic characteristics, PHQ-9 scores, ISI scores, COVID-19 questionnaires and headache profile section were included in the online questionnaires.Results: Eventually a total of 15,000 participants from China completed the online questionnaire. Among them, 2806 participants (18.71%) had preexisting headache disorders. Our analysis showed a reality of those participants with remission of headache duration (3.414±6.859 vs 4.033±7.325, P=0.000), headache days per month (1.788±2.989 vs 2.092±3.694, P=0.000), and headache intensity (4.110±1.609 vs 4.290±1.680, P=0.000), during COVID-19. Smoking (OR=1.397, 95% CI 1.090 to 1.790, P=0.008) and getting support from family members during the social isolation (OR=1.656, 95% CI 1.075 to 2.550, P=0.022) were the independent factors of remission in headache duration. Education level (OR=1.478, 95% CI 1.103 to 1.980, P=0.009) and having relative or acquaintance got COVID-19 (OR=0.643, 95% CI 0.458 to 0.902, P=0.011) were the independent factors of remission in headache severity. And participants living in Wuhan area, having COVID-19 symptoms or COVID-19 diagnosis and having relative or acquaintance got COVID-19 are more likely to get headache deteriorated.Conclusions: Participants presented an overall trend of headache remission during COVID-19. Family supports played an important role in headache remission.

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Section: Resultsmentioning

confidence: 65%

Section: Resultsmentioning

confidence: 65%

An Overall Trend of Headache Remission during COVID-19 Pandemic for Chinese Patients with Pre-existing Headache Highlights the Role of Family Supports

Gong

Liu

et al. 2020

Preprint

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“…It is mandatory in the ED setting to exclude those secondary headache disorders than can mimic migraine and are potentially life threatening (35, 36), by investigating for red flags (Table 6). Furthermore, it is essential to know the characteristics of the primary forms of migraine in order to avoid unnecessary, expensive, and potentially dangerous investigations (for example neuroradiological imaging ) .…”

Section: Primary Headachementioning

confidence: 99%

“…Red flags (Table 6) at physical examination should include headache with signs of systemic disorders (skin rash, petechiae, stiff neck, organomegaly), focal neurological signs, symptoms of disease (other than typical aura), and papilledema (35, 36).…”

Section: Evaluation Of Headache In Ed: How To Diagnose Headachementioning

confidence: 99%

Management of Childhood Headache in the Emergency Department. Review of the Literature

et al. 2019

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Headache is the third cause of visits to pediatric emergency departments (ED). According to a systematic review, headaches in children evaluated in the ED are primarily due to benign conditions that tend to be self-limiting or resolve with appropriate pharmacological treatment. The more frequent causes of non-traumatic headache in the ED include primitive headaches (21.8–66.3%) and benign secondary headaches (35.4–63.2%), whereas potentially life-threatening (LT) secondary headaches are less frequent (2–15.3%). Worrying conditions include brain tumors, central nervous system infections, dysfunction of ventriculo-peritoneal shunts, hydrocephalus, idiopathic intracranial hypertension, and intracranial hemorrhage. In the emergency setting, the main goal is to intercept potentially LT conditions that require immediate medical attention. The initial assessment begins with an in-depth, appropriate history followed by a complete, oriented physical and neurological examination. The literature describes the following red flags requiring further investigation (for example neuroimaging) for recognition of LT conditions: abnormal neurological examination; atypical presentation of headaches: subjective vertigo, intractable vomiting or headaches that wake the child from sleep; recent and progressive severe headache (<6 months); age of the child <6 years; no family history for migraine or primary headache; occipital headache; change of headache; new headache in an immunocompromised child; first or worst headache; symptoms and signs of systemic disease; headaches associated with changes in mental status or focal neurological disorders. In evaluating a child or adolescent who is being treated for headache, physicians should consider using appropriate diagnostic tests. Diagnostic tests are varied, and include routine laboratory analysis, cerebral spinal fluid examination, electroencephalography, and computerized tomography or magnetic resonance neuroimaging. The management of headache in the ED depends on the patient's general conditions and the presumable cause of the headache. There are few randomized, controlled trials on pharmacological treatment of headache in the pediatric population. Only ibuprofen and sumatriptan are significantly more effective than placebo in determining headache relief.

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“…Neuroimaging should be considered in patients with recent-onset severe headache or change in the type of headache or with associated signs or symptoms suggestive for intracranial diseases. The therapeutic management of headache in ED depends on general clinical conditions of the patients and the presumable etiology of headache [ 1 ].…”

mentioning

confidence: 99%