Karimaghaei Sam, Rook Brita S
Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Department of Ophthalmology, Arkansas Children's Hospital, Little Rock, AR 72202, USA.
Children (Basel). 2023 Feb 14;10(2):372. doi: 10.3390/children10020372.
Headache is the most common neurologic complaint that presents to the pediatrician. While most headaches are benign in nature, patients must be carefully evaluated to rule out life- or vision-threatening causes. Non-benign etiologies of headache may exhibit ophthalmologic signs and symptoms that can help narrow the differential diagnosis. It is also important for physicians to know in what situations appropriate ophthalmologic evaluation is necessary, such as evaluating for papilledema in the setting of elevated intracranial pressure. In this article we discuss life- and/or vision-threatening etiologies of headache, including infection, autoimmune disease, cerebrovascular pathologies, hydrocephalus, intracranial neoplasia, and idiopathic intracranial hypertension, and their associated ophthalmologic manifestations. Due to less familiarity of the disease amongst primary care providers, we discuss pediatric idiopathic intracranial hypertension in more comprehensive detail.
头痛是儿科医生接诊时最常见的神经科主诉。虽然大多数头痛本质上是良性的，但必须对患者进行仔细评估，以排除危及生命或视力的病因。头痛的非良性病因可能会出现眼科体征和症状，有助于缩小鉴别诊断范围。医生了解在哪些情况下需要进行适当的眼科评估也很重要，例如在颅内压升高的情况下评估视乳头水肿。在本文中，我们讨论了头痛的危及生命和/或视力的病因，包括感染、自身免疫性疾病、脑血管病变、脑积水、颅内肿瘤和特发性颅内高压，以及它们相关的眼科表现。由于初级保健提供者对该疾病的了解较少，我们将更全面详细地讨论儿童特发性颅内高压。
