Pediatric headache: embryonic tumor. Case report.
Article Sidebar
Main Article Content
Abstract
Introduction: The headache corresponds to 0.7-6.0% of pediatric emergency room consults. The pediatrician's challenge is to rule out or identify the secondary causes of headaches. Case report: 7-year-old patient consults for a holocranial headache of 15 days, who has lateralized to the left in the last seven days with pain increase, and occasionally the pain awakens her during sleep. On the physical examination, right papilledema was found, without other findings. The magnetic resonance evidenced a massive embryonic tumor of the central nervous system with a fusiform pattern with compressive effect and deviation of the midline. She required neurosurgical management, chemotherapy, and radiotherapy. Conclusions: The diagnostic approach to the headache is critical. The anamnesis must be structured, and the pediatrician should classify the headache according to its pattern. The physical examination should include analyzing the vital signs, general examination, and a neurologic evaluation with particular emphasis on the fundoscopy. The headache's diagnostic approach is based on a structured anamnesis, ruling out secondary causes. The physical examination should be meticulous and find neurological signs. In this case, the key features were the night awakening because of the pain and the papilledema.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Creative Commons
License Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)
You are free to:
Share - copy and redistribute the material in any medium or format.
Adapt - remix, transform, and build upon the material The licensor cannot revoke these freedoms as long as you follow the license terms.
• Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
• NonCommercial — You may not use the material for commercial purposes.
• ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
• No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
References
Brna PM, Dooley JM. Headaches in the Pediatric Population. Seminars in Pediatric Neurology. 2006;13(4):222-30. doi: https://doi.org/10.1016/j.spen.2006.09.003. DOI: https://doi.org/10.1016/j.spen.2006.09.003
Bille BS. Migraine in school children. A study of the incidence and short-term prognosis, and a clinical, psychological and electroencephalographic comparison between children with migraine and matched controls. Acta Paediatr Suppl. 1962;136:1-151.
Bigal ME, Lipton RB. The epidemiology, burden, and comorbidities of migraine. Neurol Clin. 2009;27(2):321-34. DOI: https://doi.org/10.1016/j.ncl.2008.11.011
Brna P, Dooley J, Gordon K, Dewan T. The Prognosis of Childhood Headache: A 20-Year Follow-up. Archives of Pediatrics & Adolescent Medicine. 2005;159(12):1157-60. doi: 10.1001/archpedi.159.12.1157. DOI: https://doi.org/10.1001/archpedi.159.12.1157
Conicella E, Raucci U, Vanacore N, Vigevano F, Reale A, Pirozzi N, et al. The Child With Headache in a Pediatric Emergency Department. Headache: The Journal of Head and Face Pain. 2008;48(7):1005-11. doi: https://doi.org/10.1111/j.1526-4610.2007.01052.x. DOI: https://doi.org/10.1111/j.1526-4610.2007.01052.x
Hsiao H-J, Huang J-L, Hsia S-H, Lin J-J, Huang IA, Wu C-T. Headache in the Pediatric Emergency Service: A Medical Center Experience. Pediatrics & Neonatology. 2014;55(3):208-12. doi: 10.1016/j.pedneo.2013.09.008. DOI: https://doi.org/10.1016/j.pedneo.2013.09.008
Kan L, Nagelberg J, Maytal J. Headaches in a Pediatric Emergency Department: Etiology, Imaging, and Treatment. Headache: The Journal of Head and Face Pain. 2000;40(1):25-9. doi: https://doi.org/10.1046/j.1526-4610.2000.00004.x. DOI: https://doi.org/10.1046/j.1526-4610.2000.00004.x
Rothner AD. The evaluation of headaches in children and adolescents. Seminars in Pediatric Neurology. 1995;2(2):109-18. doi: https://doi.org/10.1016/S1071-9091(05)80021-X. DOI: https://doi.org/10.1016/S1071-9091(05)80021-X
Hershey AD. Pediatric Headache. Continuum (Minneap Minn). 2015;21(4 Headache):1132-45. Epub 2015/08/08. doi: 10.1212/con.0000000000000197. DOI: https://doi.org/10.1212/CON.0000000000000197
Caviness V, Ebinger F. Headache in pediatric practice. Handb Clin Neurol. 2013;112:827-38. Epub 2013/04/30. doi: 10.1016/b978-0-444-52910-7.00002-7. PubMed PMID: 23622290. DOI: https://doi.org/10.1016/B978-0-444-52910-7.00002-7
Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211. doi: 10.1177/0333102417738202. DOI: https://doi.org/10.1177/0333102417738202
Gelfand AA. Pediatric and Adolescent Headache. Continuum (Minneap Minn). 2018;24(4, Headache):1108-36. Epub 2018/08/04. doi: 10.1212/con.0000000000000638. DOI: https://doi.org/10.1212/CON.0000000000000638
Dooley JM, Gordon KE, Wood EP, Camfield CS, Camfield PR. The utility of the physical examination and investigations in the pediatricneurology consultation. Pediatric Neurology. 2003;28(2):96-9. doi: 10.1016/S0887-8994(02)00494-0. DOI: https://doi.org/10.1016/S0887-8994(02)00494-0
Rothner AD. Headaches in children and adolescents: update 2001. Semin Pediatr Neurol. 2001;8(1):2-6. doi: 10.1053/spen.2001.23325. DOI: https://doi.org/10.1053/spen.2001.23325
Piatt JH, Jr. Recognizing neurosurgical conditions in the pediatrician's office. Pediatr Clin North Am. 2004;51(2):237-70. doi: 10.1016/s0031-3955(03)00213-x. DOI: https://doi.org/10.1016/S0031-3955(03)00213-X
Babineau SE, Green MW. Headaches in children. Continuum (Minneap Minn). 2012;18(4):853-68. doi: 10.1212/01.CON.0000418647.77773.4e. DOI: https://doi.org/10.1212/01.CON.0000418647.77773.4e
Jacobs H, Gladstein J. Pediatric Headache: A Clinical Review. Headache: The Journal of Head and Face Pain. 2012;52(2):333-9. doi: https://doi.org/10.1111/j.1526-4610.2011.02086.x. DOI: https://doi.org/10.1111/j.1526-4610.2011.02086.x