Division of Pediatric Emergency Medicine, Department of Pediatrics, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Sourasky Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Headache. 2019 Oct;59(9):1530-1536. doi: 10.1111/head.13607. Epub 2019 Jul 26.
Headache is a common complaint in children at a pediatric emergency department (PED). The primary objective of this analysis is to describe the outcome of patients presenting with headache to the PED and discharged with neurology follow up. The secondary objective is to describe the diagnostic evaluation children with headache underwent in the PED and to evaluate headache characteristics which are more likely associated with serious, life-threatening conditions.
A retrospective chart review of children who were discharged from the PED after evaluation for headache, with a scheduled urgent neurology outpatient clinic follow up at the same institution, over a 3.5-year period.
During the study period, we identified 300 children whose admitting diagnosis was headache and they were discharged from the PED with a scheduled follow up. None of these patients had papilledema on fundoscopy performed by an ophthalmologist during the PED visit. Following neurology outpatient clinic visit, 62 (21%) were referred to perform brain magnetic resonance imaging. None of the patients had a diagnosis of brain tumor or any anatomic abnormality that could increase intracranial pressure.
No immediate life-threatening cases presented to the follow up neurology clinic for evaluation. A scheduled urgent neurology outpatient clinic follow up in any child with headache who is discharged from the PED, offers a safety net, even when the physical examination including fundoscopy is normal.
头痛是儿科急诊部（PED）常见的儿童主诉。本分析的主要目的是描述因头痛就诊 PED 并接受神经科随访出院的患者的结局。次要目的是描述在 PED 中接受头痛诊断评估的儿童，并评估更可能与严重危及生命的情况相关的头痛特征。
对在同一机构接受头痛评估后从 PED 出院并安排紧急神经科门诊随访的 3.5 年期间的患儿进行回顾性图表审查。
在研究期间，我们确定了 300 名因头痛而被诊断为入院的患儿，并从 PED 出院，安排了随访。在 PED 就诊期间，没有一位患儿的眼底镜检查显示视乳头水肿。在神经科门诊就诊后，62 例（21%）被转介进行脑部磁共振成像检查。患儿均未被诊断为脑瘤或任何可增加颅内压的解剖异常。
在后续神经科诊所就诊评估的患者中，没有出现危及生命的即时病例。对从 PED 出院的任何头痛患儿进行计划中的紧急神经科门诊随访，提供了安全网，即使体检包括眼底镜检查均正常。
