J Biomed Transl Res.  2016 Mar;17(1):8-12. 10.12729/jbtr.2016.17.1.008.

The diagnostic types of headaches in the pediatric emergency department in Korea

Affiliations
  • 1Department of Pediatrics, Cheonju St. Mary's Hospital, Cheongju 28323, Korea.
  • 2Department of Preventive Medicine, College of Medicine, Chungbuk National University, Cheongju 28644, Korea.
  • 3Department of Pediatrics, Chungbuk National University Hospital, Chungbuk National University, College of Medicine, Cheongju 28608, Korea. wskim@chungbuk.ac.kr

Abstract

Headache is one of most common chief complaints of pediatric patients in emergency departments (ED). In this study, the character, duration, strength and location of headaches, as well as the results of brain imaging studies, were recorded. Seventy-four children (34 boys, 40 girls) visiting the ED of major hospitals in Cheongju were enrolled from October 1, 2013 to September 30, 2014. Ages of the children ranged from 3 to 18 years, with the mean age being 13 years. Four of them (5.4%) had trauma-related headaches. There were 34 migraines (45.9%), 27 tension headaches (36.5%), 3 secondary headaches (4.1%), 2 seizure-related headaches (2.7%), 1 headache with hydrocephalus (1.4%), 1 concussion (1.4%), and 1 headache with subdural hematoma (1.4%). The highest number of patients, 31 (41.9%), had symptoms for less than two hours, while 11 pediatric patients (14.9%) had symptoms for 2-4 hours, and the third-largest group, 10 patients (13.5%), had symptoms between 24 and 72 hours. Twenty-nine patients (39.2%) had one headache per month, 20 patients (27.0%) had 1 to 14 headaches per month, and 4 patients (5.4%) had more than 15 headaches per month. Children with migraine took a nonsteroidal anti-inflammatory drugs (NSAID, 34 patients; 45.9%), acetaminophen (19 patients; 25.7%), and Topiramate (1 patient; 1.4%). Average strength of headache was 7.37 ± 1.79. There were 23 children (31.1%) with headaches in the parieto-temporal area, 16 children (21.6%) in the occipital area, 9 children (12.2%) in the frontal area, 4 children (5.4%) in the global area, and 6 children (8.1%) in an uncertain location. There were 31 children (41.9%) with pulsating headaches, 18 children (24.3%) with squeezing headaches, 5 children (6.8%) with stabbing headaches, and 11 children (14.9%) with headaches of an uncertain nature. Thus, we suspect children visiting the ED had severe headaches.

Keyword

headache; migraine; emergency department; diagnosis; treatment

MeSH Terms

Acetaminophen
Child
Chungcheongbuk-do
Diagnosis
Emergencies*
Emergency Service, Hospital*
Headache*
Hematoma, Subdural
Humans
Hydrocephalus
Korea*
Migraine Disorders
Neuroimaging
Tension-Type Headache
Acetaminophen
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