Jan M M, Camfield P R, Gordon K, Camfield C S
Division of Child Neurology, Department of Pediatrics, IWK-Grace Health Centre and Dalhousie University Medical School, Halifax, Nova Scotia, Canada.
J Pediatr. 1997 Jan;130(1):134-7. doi: 10.1016/s0022-3476(97)70322-6.
To determine whether vomiting after mild head injury in children is related to migraine and to identify predictors of vomiting after head injury.
A series of consecutive children admitted to the observation unit of an emergency department after mild head injury was identified by chart review. A telephone interview with the parents or child or both was then conducted by using a structured questionnaire.
Of 47 eligible children with acute head injury, 44 (94%) were contacted. The mean age at head injury was 7.4 years. Twenty-nine children (66%) vomited after the head injury. The likelihood of vomiting was increased if the child had a history of recurrent headache (p = 0.05). If the headaches were migrainous, the likelihood of vomiting increased further (p <0.002). All 15 children with a history of motion sickness vomited after the head injury. Family history of migraine, particularly maternal (n = 21), also predicted recurrent vomiting (p <0.001). If more than one of these predictive variables was present, the likelihood of vomiting was 100%.
History of motion sickness, migraine headaches, and family history of migraine are highly predictive of vomiting after a mild head injury.
确定儿童轻度头部损伤后呕吐是否与偏头痛有关，并确定头部损伤后呕吐的预测因素。
通过病历审查确定一系列在轻度头部损伤后入住急诊科观察病房的连续儿童。然后使用结构化问卷对父母或儿童或两者进行电话访谈。
在47名符合条件的急性头部损伤儿童中，44名（94%）被联系上。头部损伤时的平均年龄为7.4岁。29名儿童（66%）在头部损伤后呕吐。如果儿童有复发性头痛史，呕吐的可能性会增加（p = 0.05）。如果头痛是偏头痛性的，呕吐的可能性会进一步增加（p <0.002）。所有15名有晕动病史的儿童在头部损伤后都呕吐了。偏头痛家族史，尤其是母亲的偏头痛家族史（n = 21），也可预测反复呕吐（p <0.001）。如果存在多个这些预测变量，呕吐的可能性为100%。
晕动病史、偏头痛性头痛和偏头痛家族史对轻度头部损伤后呕吐具有高度预测性。
