Diagnosis and Management of Childhood Headache

Gofshteyn, Jacqueline S.; Stephenson, Donna J.

doi:10.1016/j.cppeds.2015.11.003

Cited by 34 publications

(37 citation statements)

References 64 publications

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“…In most of our patients, the absence of focal neurological findings and the presence of clinical or radiological evidence of upper or lower respiratory tract infections were relevant to secondary headaches. 24 The mean age of patients with headaches was greater than that of patients without headaches in our study. This may be related to the inability to articulate the presence of a headache at an earlier age.…”

Section: Discussioncontrasting

confidence: 58%

Neurological Involvement in Pediatric Hemolytic Uremic Syndrome: A Symptom-Oriented Analysis

et al. 2017

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Background Neurological involvement is common in hemolytic uremic syndrome (HUS), but each neurological symptom may be due to a variety of factors. Objective We aimed to evaluate predisposing factors to the neurological symptoms in HUS. Materials and Methods The 10-year follow-up data on HUS patients were retrospectively analyzed. Statistical comparisons were made across subgroups based on age and neurological symptoms. Results The neurological involvement rate was 37.5%. The female-to-male ratio increased in patients with neurological involvement (3.8 vs. 1.37). Regarding all HUS patients, hemoglobin levels were higher in patients with paresis. The rate of paresis was twofold higher in patients with a hemoglobin level above 11 g/dL (p < 0.05). In diarrhea-associated HUS patients, D-dimer and C-reactive protein levels were higher in patients with paresis, and leukocyte counts were higher in patients with seizures. Patients with altered consciousness had higher creatinine levels. The survival rate was significantly lower in patients with a reticulocyte percentage of less than 2% (50 vs. 100%). Conclusion Results of our study indicate that neurological involvement depends on overall findings in HUS. A symptom-oriented approach, which is different from that employed in previous studies, reveals some clues to the pathogenesis and management of these patients.

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Section: Discussioncontrasting

confidence: 58%

Neurological Involvement in Pediatric Hemolytic Uremic Syndrome: A Symptom-Oriented Analysis

et al. 2017

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“…The pneumonic SNOOP has been used to indicate features that could raise clinical concern and warrant imaging in both adult and pediatric populations such as the presence of the following: systemic symptoms (eg, fever, HIV), neurologic signs, onset pattern (eg, thunderclap, sudden), older age onset, or pattern change. [14][15][16][17] Other red flags include papilledema, systemic illness including rash or neck stiffness, headache triggered by cough or exertion, headache and pregnancy (or postpartum period), worst headache of one's life, and so forth. 1 The American College of Radiology has endeavored to provide guidance for imaging of patients with headache based on a number of clinical variants.…”

Section: Classification Schemesmentioning

confidence: 99%

“…33 For example, a significantly scaleddown version of a brain MR imaging examination might suffice with 1 or 2 sequences, while being less costly than conventional brain MR imaging protocols. 15 Moreover, patient cost-sharing could select patients who have a strong desire for imaging despite the absence of good clinical indications or red flags. In such cases, the patient's willingness to pay could inform policy prescriptions and decision-making, while reducing the burden on payers.…”

Section: Potential Remedies and Future Directionsmentioning

confidence: 99%

Headache and Neuroimaging: Why We Continue to Do It

Jordan

Flanders

2020

AJNR Am J Neuroradiol

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The appropriate imaging of patients with headache presents a number of important and vexing challenges for clinicians. Despite a number of guidelines and studies demonstrating a lack of cost-effectiveness, clinicians continue to image patients with chronic nonfocal headaches, and the trend toward imaging is increasing. The reasons are complex and include the fear of missing a clinically significant lesion and litigation, habitual and standard of care practices, lack of tort reform, regulatory penalties and potential impact on one's professional reputation, patient pressures, and financial motivation. Regulatory and legislative reforms are needed to encourage best practices without fear of professional sanctions when following the guidelines. The value of negative findings on imaging tests requires better understanding because they appear to provide some measure of societal value. Clinical decision support tools and machine intelligence may offer additional guidance and improve quality and cost-efficient management of this challenging patient population.

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“…Paediatric headache is one of the most common presenting concerns of families accessing medical care (1). Mild, transient, and isolated paediatric headaches are typically managed without accessing medical care, whereas severe, long-lasting, and recurrent headaches cause significant suffering and often result in decreased quality of life through interference with school and social activities (2).…”

Section: Introductionmentioning

confidence: 99%

“…Primary headaches do not have an underlying medical cause and include migraines, tension-type headache (TTH), and cluster headaches. Migraine and TTH are the most common primary headaches in children (1), and recommended management includes both pharmacological and nonpharmacological therapies (1,2).…”

Section: Introductionmentioning

confidence: 99%

Relaxation training for management of paediatric headache: A rapid review

Thompson

Jou

et al. 2019

Paediatrics &Amp; Child Health

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The objective of this review was to assess the evidence on relaxation training for management of paediatric headaches. Our methodology was a rapid review of English-language peer reviewed published literature focused on studies evaluating relaxation training as a primary or adjunct management option for headache in a paediatric population (0 to 18 years of age). Seven studies involving 571 children were included in the review. The quality of evidence was very low using GRADE criteria. Headache frequency, duration, and intensity were the primary outcomes in the included studies. Results for the effects of relaxation training for paediatric headache are inconsistent. Four of the seven studies reported decreased headache frequency, two of the five studies reported decreased headache duration, and two of the six studies reported decreased headache intensity following relaxation training. No adverse events were reported. The current state of the evidence for relaxation training for management of paediatric headache is both inconsistent and of very low quality. High-quality research evaluating the effects of relaxation training for paediatric headaches is required to advance the field.

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Diagnosis and Management of Childhood Headache

Cited by 34 publications

References 64 publications

Neurological Involvement in Pediatric Hemolytic Uremic Syndrome: A Symptom-Oriented Analysis

Neurological Involvement in Pediatric Hemolytic Uremic Syndrome: A Symptom-Oriented Analysis

Headache and Neuroimaging: Why We Continue to Do It

Relaxation training for management of paediatric headache: A rapid review

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