Department of Neurology, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan.
Pediatr Int. 2022 Jan;64(1):e15181. doi: 10.1111/ped.15181.
Headaches are very common in children. The patients often have mild symptoms, but on occasion may have severe, secondary headaches. The present study aimed to clarify the details of children with headaches seen at the outpatient clinic of a pediatric neurological department.
The present, retrospective observational study was conducted at a tertiary pediatric hospital in Japan and enrolled children referred to the neurology department outpatient clinic for headache between April 2018 and March 2021.
In total, 113 cases of headache were examined; of these, 99 (87.6%) were primary headaches, one case (0.9%) was a secondary headache, and 13 (11.5%) were unclassified or unspecified. There were 46 cases (40.7%) of tension-type headache (TTH), both confirmed and suspected, 30 cases (26.5%) of migraine, and 23 cases (20.4%) of a combination of the TTH and migraine. One case of secondary headache was attributed to an infection. Arachnoid cysts were found in seven patients (7.8%). Acute drug treatments were administered to 93 patients (82.3%), with acetaminophen being the most common drug, followed by ibuprofen. Prophylactic drug treatments were administered to 39 patients (34.5%), with goreisan (a Chinese herbal medicine containing Alisma orientale, Poria cocos, Polyporus umbellatus, Atractylodes lancea, and Cinnamomum cassia) being the most common (41%).
Few cases of secondary headache and none of emergency headache were diagnosed. The prevalence of arachnoid cysts was higher than in the general pediatric population, suggesting that arachnoid cysts might be associated with headache.
头痛在儿童中非常常见。患者常表现为轻症，但偶尔也会出现严重的继发性头痛。本研究旨在阐明在小儿神经科门诊就诊的头痛患儿的详细情况。
本回顾性观察研究在日本一家三级儿科医院进行，纳入 2018 年 4 月至 2021 年 3 月期间因头痛到神经科门诊就诊的儿童。
共检查了 113 例头痛病例；其中，99 例（87.6%）为原发性头痛，1 例（0.9%）为继发性头痛，13 例（11.5%）为未分类或未明确。其中 46 例（40.7%）为紧张型头痛（TTH），包括确诊和疑似病例，30 例（26.5%）为偏头痛，23 例（20.4%）为 TTH 和偏头痛的组合。1 例继发性头痛归因于感染。7 例患者（7.8%）发现蛛网膜囊肿。93 例患者（82.3%）接受了急性药物治疗，最常用的药物是对乙酰氨基酚，其次是布洛芬。39 例患者（34.5%）接受了预防性药物治疗，最常用的药物是葛根汤（一种含有泽泻、茯苓、猪苓、白术和肉桂的中药）（41%）。
诊断出的继发性头痛和紧急性头痛病例很少。蛛网膜囊肿的患病率高于一般儿科人群，提示蛛网膜囊肿可能与头痛有关。
