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对因头痛前来儿科神经科门诊就诊的儿童进行脑部成像检查。

Brain imaging in children referred to pediatric neurology out-patients with headache.

作者信息

Sarı Emine Ergül, Bektaş Gonca, Palabıyik Figen, Hatipoğlu Sadık Sami

机构信息

Bakırköy Dr. Sadi Konuk Training and Research Hospital, Department of Pediatrics, Istanbul, Turkey.

Bakırköy Dr. Sadi Konuk Training and Research Hospital, Department of Pediatric Neurology, Istanbul, Turkey.

出版信息

J Pediatr (Rio J). 2025 May-Jun;101(3):356-361. doi: 10.1016/j.jped.2024.11.005. Epub 2024 Dec 7.

Abstract

OBJECTIVE

Headaches are common in children and adolescents as well as in adults. Due to the fact that the primary medical concern for children presenting with headache complaints is the possibility of intracranial pathology, nowadays, imaging methods are frequently used in those patients.

METHODS

Retrospective data analysis was performed on the records of children who attended the Pediatric Neurology Outpatient Clinic between June 01, 2018, and December 01, 2018, complaining of headaches. Children who had a headache for longer than four weeks and had brain magnetic resonance imaging were included in the study. Brain MRI findings were classified as (1) headache-related and requiring definitive intervention, (2) possibly headache-related abnormalities, (3) headache-related abnormalities that did not require intervention, and (4) normal.

RESULTS

The 387 patients included in the study were between the ages of 2 and 17, with a median age of 10.5 years. Of the patients, 234 were female and 153 were male. The duration of the headache was a median of 12 months. According to brain MRI findings, 253 patients (65%) were in group 4, 79 patients (20%) were in group 2, 54 patients (14%) were in group 3, and 1 patient (0.3%) was in group 1.

CONCLUSION

The probability of detecting significant abnormalities with brain MRI in children with chronic headaches with normal neurological examination is found to be low. Imaging methods should be kept in mind that they may be useful in diagnosis in selected cases.

摘要

目的

头痛在儿童、青少年及成人中都很常见。由于出现头痛症状的儿童首要的医疗关注点是颅内病变的可能性,如今,成像方法在这些患者中经常被使用。

方法

对2018年6月1日至2018年12月1日期间到儿科神经科门诊就诊且主诉头痛的儿童病历进行回顾性数据分析。纳入研究的儿童为头痛持续时间超过四周且进行了脑磁共振成像检查的。脑MRI检查结果分为:(1)与头痛相关且需要明确干预;(2)可能与头痛相关的异常;(3)与头痛相关但无需干预的异常;(4)正常。

结果

纳入研究的387例患者年龄在2至17岁之间,中位年龄为10.5岁。其中,女性234例,男性153例。头痛持续时间的中位数为12个月。根据脑MRI检查结果,253例患者(65%)属于第4组,79例患者(20%)属于第2组,54例患者(14%)属于第3组,1例患者(0.3%)属于第1组。

结论

对于神经系统检查正常的慢性头痛儿童,通过脑MRI检测到明显异常的可能性较低。应记住,成像方法在某些特定病例的诊断中可能有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f8d/12039369/a6f2d342714d/gr1.jpg

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