Headache etiology in children: A retrospective study of 125 cases

Background: To determine the headache etiology in children in the middle An atolia region of Turkey. Methods: The clinical and laboratory findings of 125 patients, who were fol lowed up after a diagnosis of headache in our hospital, were reviewed retro spectively. The criteria defined by the International Headache Society (IHS ) were used in the classification of patients. The patients were divided in to two subgroups according to age intervals: (i) group I, 5-10 years of age ; and (ii) group II! 11-16 years of age. Results: There were 62 males and 63 females in the study. The patients' age s ranged from 5 to 16 years (mean (+/- SD) age 10.67 +/- 2.72 years). Heada che was more commonly noted between Il and 16 years of age. While headache was more frequent in male children in group I, there was female predominanc e in group II. However, there was no significant difference between the gro ups with respect to age and gender (P > 0.05). The most frequent cause of h eadache was migraine and the remaining causes, in decreasing order, include d sinusitis (no. 11 according to IHS criteria) and tension-type and psychos omatic headaches (no. 13 according to IHS criteria). Of the 125 patients in the study, 85 (68%) had acute headache and 40 (32%) had chronic headache; 44 (35.2%) patients had acute localized-type headache, 39 (31.2%) suffered from acute recurrent-type headache, 38 (30.4%) had chronic non-progressive headache and acute generalized and chronic progressive-type headache were d iagnosed in two (1.6%) patients. Computed tomography (CT) and magnetic reso nance imaging (MRI) of the brain were performed in 50 and seven patients, r espectively; there were abnormal findings in six patients on CT examiniatio n and in two patients following MRI. Conclusions: In conclusion, we stress that the most frequent cause of heada che in childhood is migraine and the remaining causes, in decreasing order of frequency, were sinusitis and tension-type and psychosomatic headaches. Neuroimaging studies, such as CT or MRI, need to be performed, especially i n patients with complicated symptoms.