Headache in the Pediatric Emergency Service: A Medical Center Experience

Headache is a common complaint in children and is one of the most common reasons for presentation at a pediatric emergency department (PED). This study described the etiologies of patients with headache seen in the PED and determined predictors of intracranial pathology (ICP) requiring urgent interv...

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Main Authors: Hsiang-Ju Hsiao, Jing-Long Huang, Shao-Hsuan Hsia, Jainn-Jim Lin, I-Anne Huang, Chang-Teng Wu
Format: Article
Language:English
Published: Elsevier 2014-06-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S187595721300185X
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author Hsiang-Ju Hsiao
Jing-Long Huang
Shao-Hsuan Hsia
Jainn-Jim Lin
I-Anne Huang
Chang-Teng Wu
author_facet Hsiang-Ju Hsiao
Jing-Long Huang
Shao-Hsuan Hsia
Jainn-Jim Lin
I-Anne Huang
Chang-Teng Wu
author_sort Hsiang-Ju Hsiao
collection DOAJ
description Headache is a common complaint in children and is one of the most common reasons for presentation at a pediatric emergency department (PED). This study described the etiologies of patients with headache seen in the PED and determined predictors of intracranial pathology (ICP) requiring urgent intervention. A secondary objective was to develop rapid, practical tools for screening headache in the PED. Methods: We conducted a retrospective chart review of children who presented with a chief complaint of headache at the PED during 2008. First, we identified possible red flags in the patients' history or physical examination and neurological examination findings. Then, we recorded the brain computed tomography results. Results: During the study period, 43,913 visits were made to the PED; in 409 (0.9%) patients, the chief complaint was headache. Acute viral, respiratory, and febrile illnesses comprised the most frequent cause of headache (59.9%). Six children (1.5%) had life-threatening ICP findings. In comparison with the group without ICP, the group with ICP had a significantly higher percentage of blurred vision (p = 0.008) and ataxia (p = 0.002). Conclusion: Blurred vision and ataxia are the best clinical parameters to predict ICP findings.
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spelling doaj-art-9f5d8bd894f445b9803cf743d4e48fef2025-08-20T03:04:00ZengElsevierPediatrics and Neonatology1875-95722014-06-0155320821210.1016/j.pedneo.2013.09.008Headache in the Pediatric Emergency Service: A Medical Center ExperienceHsiang-Ju Hsiao0Jing-Long Huang1Shao-Hsuan Hsia2Jainn-Jim Lin3I-Anne Huang4Chang-Teng Wu5Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, College of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital at Keelung, College of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan, TaiwanHeadache is a common complaint in children and is one of the most common reasons for presentation at a pediatric emergency department (PED). This study described the etiologies of patients with headache seen in the PED and determined predictors of intracranial pathology (ICP) requiring urgent intervention. A secondary objective was to develop rapid, practical tools for screening headache in the PED. Methods: We conducted a retrospective chart review of children who presented with a chief complaint of headache at the PED during 2008. First, we identified possible red flags in the patients' history or physical examination and neurological examination findings. Then, we recorded the brain computed tomography results. Results: During the study period, 43,913 visits were made to the PED; in 409 (0.9%) patients, the chief complaint was headache. Acute viral, respiratory, and febrile illnesses comprised the most frequent cause of headache (59.9%). Six children (1.5%) had life-threatening ICP findings. In comparison with the group without ICP, the group with ICP had a significantly higher percentage of blurred vision (p = 0.008) and ataxia (p = 0.002). Conclusion: Blurred vision and ataxia are the best clinical parameters to predict ICP findings.http://www.sciencedirect.com/science/article/pii/S187595721300185Xchildrencomputed tomographyemergency departmentheadache
spellingShingle Hsiang-Ju Hsiao
Jing-Long Huang
Shao-Hsuan Hsia
Jainn-Jim Lin
I-Anne Huang
Chang-Teng Wu
Headache in the Pediatric Emergency Service: A Medical Center Experience
Pediatrics and Neonatology
children
computed tomography
emergency department
headache
title Headache in the Pediatric Emergency Service: A Medical Center Experience
title_full Headache in the Pediatric Emergency Service: A Medical Center Experience
title_fullStr Headache in the Pediatric Emergency Service: A Medical Center Experience
title_full_unstemmed Headache in the Pediatric Emergency Service: A Medical Center Experience
title_short Headache in the Pediatric Emergency Service: A Medical Center Experience
title_sort headache in the pediatric emergency service a medical center experience
topic children
computed tomography
emergency department
headache
url http://www.sciencedirect.com/science/article/pii/S187595721300185X
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AT jinglonghuang headacheinthepediatricemergencyserviceamedicalcenterexperience
AT shaohsuanhsia headacheinthepediatricemergencyserviceamedicalcenterexperience
AT jainnjimlin headacheinthepediatricemergencyserviceamedicalcenterexperience
AT iannehuang headacheinthepediatricemergencyserviceamedicalcenterexperience
AT changtengwu headacheinthepediatricemergencyserviceamedicalcenterexperience