Park Eu Gene, Han Seung Beom, Lee Jin, Kim Jee Min, Han Ji Yoon
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Department of Pediatrics, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 21431, Republic of Korea.
Brain Sci. 2024 Sep 24;14(10):951. doi: 10.3390/brainsci14100951.
Headache is a common complaint during childhood and adolescence. It is important to be aware of the characteristics of pediatric headaches in order to make a precise and timely diagnosis. This study investigated the clinical characteristics of pediatric headaches according to the underlying etiology and age group.
We retrospectively reviewed the medical records of 3374 pediatric patients (2667 with primary headache [PH] and 707 with secondary headache [SH]) who presented with headaches at two centers between January 2012 and November 2023.
The incidence of PH was significantly higher in adolescents (40.1% vs. 22.9%), whereas that of SH was considerably higher in preschoolers (37.5% vs. 16.3%) ( < 0.001). The prevalence of headaches attributed to infection was significantly higher in preschool and school-aged children (90.8% vs. 80.2%, < 0.001); adolescents exhibited significantly higher frequencies of cranial and cervical vascular disorders (3.7% vs. 1.3%, = 0.044) and psychiatric disorders (5.6% vs. 0.6%, < 0.001). Statistically significant differences were observed between preschool/school-aged children and adolescents in terms of headache characteristics and the prevalence of headache-associated symptoms (60.4% vs. 74.1%, < 0.001 in PH), neurologic abnormalities (10.2% vs. 23.6%, < 0.001 in PH; 2.4% vs. 11.7%, < 0.001 in SH), and headache triggers (19.9% vs. 24.2%, = 0.008 in PH; 2.0% vs. 8.0%, < 0.001 in SH).
Recognizing the etiology and age-specific differences in the clinical characteristics of headaches is crucial for an accurate and timely diagnosis. Tailoring the diagnostic approach accordingly helps to achieve optimal outcomes in pediatric patients with headaches.
头痛是儿童和青少年时期常见的主诉。了解小儿头痛的特征对于准确及时的诊断很重要。本研究根据潜在病因和年龄组调查了小儿头痛的临床特征。
我们回顾性分析了2012年1月至2023年11月期间在两个中心因头痛就诊的3374例儿科患者的病历（2667例原发性头痛[PH]和707例继发性头痛[SH]）。
青少年原发性头痛的发病率显著更高（40.1%对22.9%），而学龄前儿童继发性头痛的发病率则显著更高（37.5%对16.3%）（<0.001）。学龄前和学龄儿童中因感染引起的头痛患病率显著更高（90.8%对80.2%，<0.001）；青少年中颅颈血管疾病（3.7%对1.3%，=0.044）和精神疾病（5.6%对0.6%，<0.001）的发生率显著更高。在头痛特征以及头痛相关症状的患病率（原发性头痛中60.4%对74.1%，<0.001）、神经学异常（原发性头痛中10.2%对23.6%，<0.001；继发性头痛中2.4%对11.7%，<0.001）和头痛触发因素（原发性头痛中19.9%对24.2%，=0.008；继发性头痛中2.0%对8.0%，<0.001）方面，学龄前/学龄儿童和青少年之间观察到统计学上的显著差异。
认识到头痛临床特征的病因及年龄特异性差异对于准确及时的诊断至关重要。相应地调整诊断方法有助于在小儿头痛患者中取得最佳治疗效果。
