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    Clinical Analysis and Red Flag Signs in Pediatric Headache According to Age

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    https://www.riss.kr/link?id=A109016252

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      Yoon Hee Jo (Department of Pediatrics, Pusan National University Hospital, Biomedical Research Institute, Pusan National University School of Medicine, Busan, Korea) ;  Yoo Jung Lee (Department of Pediatrics, Pusan National University Hospital, Biomedical Research Institute, Pusan National University School of Medicine, Busan, Korea) ;  Donghyun Shin (Department of Pediatrics, Pusan National University Hospital, Biomedical Research Institute, Pusan National University School of Medicine, Busan, Korea) ;  Soo Young Lyu (Department of Pediatrics, Pusan National University Children’s Hospital, Pusan National University School of Medicine, Yangsan, Korea) ;  Ju Hyun Kong (Department of Pediatrics, Pusan National University Children’s Hospital, Biomedical Research Institute, Pusan National University School of Medicine, Yangsan, Korea) ;  Yun-Jin Lee (Department of Pediatrics, Pusan National University Children’s Hospital, Pusan National University School of Medicine, Yangsan, Korea) ;  Sang Ook Nam (Department of Pediatrics, Pusan National University Children’s Hospital, Biomedical Research Institute, Pusan National University School of Medicine, Yangsan, Korea) ;  Young Mi Kim (Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea)

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      2024

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    다국어 초록 (Multilingual Abstract) kakao i 다국어 번역

    Purpose: The clinical characteristics of headaches vary by age among pediatric patients. Red flag signs are key factors in differentiating secondary headaches and should be considered in the context of the patient’s age. Methods: This study involved a retrospective chart review of pediatric patients presenting with headaches. Patients were categorized by age into three groups: pre-school age (under 6 years), school-age (6 to 12 years), and adolescence (over 12 years). Demographic data, headache characteristics, laboratory findings, and neuroimaging results were evaluated. Overall, 17 potential red flags were assessed. Results: A total of 687 patients were included, of whom 102 were of pre-school age, 314 were school-aged, and 271 were adolescents. The frequency of overweight/obesity was found to increase with age. The pre-school age group experienced a shorter period from symptom onset to presentation and a briefer duration of pain. In contrast, adolescents displayed a longer period from symptom onset, a greater frequency of headaches occurring at least three times per week, and a higher rate of headache episodes lasting over 3 days. Children under 6 years old were more commonly diagnosed with secondary headaches than older children. Across age groups, secondary headaches were suspected when systemic symptoms such as fever were present, when the headache had a sudden onset, when the patient responded poorly to medication, or when abnormal neurological signs and symptoms were observed. Conclusion: The clinical features of pediatric patients vary by age group. Clinicians should consider red flag signs in the context of patient age and individual characteristics.
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    Purpose: The clinical characteristics of headaches vary by age among pediatric patients. Red flag signs are key factors in differentiating secondary headaches and should be considered in the context of the patient’s age. Methods: This study involved...

    Purpose: The clinical characteristics of headaches vary by age among pediatric patients. Red flag signs are key factors in differentiating secondary headaches and should be considered in the context of the patient’s age. Methods: This study involved a retrospective chart review of pediatric patients presenting with headaches. Patients were categorized by age into three groups: pre-school age (under 6 years), school-age (6 to 12 years), and adolescence (over 12 years). Demographic data, headache characteristics, laboratory findings, and neuroimaging results were evaluated. Overall, 17 potential red flags were assessed. Results: A total of 687 patients were included, of whom 102 were of pre-school age, 314 were school-aged, and 271 were adolescents. The frequency of overweight/obesity was found to increase with age. The pre-school age group experienced a shorter period from symptom onset to presentation and a briefer duration of pain. In contrast, adolescents displayed a longer period from symptom onset, a greater frequency of headaches occurring at least three times per week, and a higher rate of headache episodes lasting over 3 days. Children under 6 years old were more commonly diagnosed with secondary headaches than older children. Across age groups, secondary headaches were suspected when systemic symptoms such as fever were present, when the headache had a sudden onset, when the patient responded poorly to medication, or when abnormal neurological signs and symptoms were observed. Conclusion: The clinical features of pediatric patients vary by age group. Clinicians should consider red flag signs in the context of patient age and individual characteristics.

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    참고문헌 (Reference)

    1 Westgate CS, "Understanding the link between obesity and headache-with focus on migraine and idiopathic intracranial hypertension" 22 : 123-, 2021

    2 Lewis DW, "The utility of neuroimaging in the evaluation of children with migraine or chronic daily headache who have normal neurological examinations" 40 : 629-632, 2000

    3 Park EG, "The diagnostic values of red flags in pediatric patients with headache" 44 : 512-519, 2022

    4 Headache Classification Committee of the International Headache Society(IHS), "The International Classification of Headache Disorders, 3rd edition" 38 : 1-211, 2018

    5 Abu-Arafeh I, "Serious neurological disorders in children with chronic headache" 90 : 937-940, 2005

    6 Gungor A, "Retrospective evaluation of acute headache in pediatric emergency department : etiologies, red flags, and neuroimaging" 27 : 95-99, 2022

    7 Conti R, "Red flags presented in children complaining of headache in paediatric emergency department" 10 : 366-, 2023

    8 Tsze DS, "Red flag findings in children with headaches : prevalence and association with emergency department neuroimaging" 39 : 185-196, 2019

    9 Lewis DW, "Practice parameter : evaluation of children and adolescents with recurrent headaches : report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society" 59 : 490-498, 2002

    10 Yayici Koken O, "Pediatric headache : are the red flags misleading or prognostic?" 43 : 372-379, 2021

    1 Westgate CS, "Understanding the link between obesity and headache-with focus on migraine and idiopathic intracranial hypertension" 22 : 123-, 2021

    2 Lewis DW, "The utility of neuroimaging in the evaluation of children with migraine or chronic daily headache who have normal neurological examinations" 40 : 629-632, 2000

    3 Park EG, "The diagnostic values of red flags in pediatric patients with headache" 44 : 512-519, 2022

    4 Headache Classification Committee of the International Headache Society(IHS), "The International Classification of Headache Disorders, 3rd edition" 38 : 1-211, 2018

    5 Abu-Arafeh I, "Serious neurological disorders in children with chronic headache" 90 : 937-940, 2005

    6 Gungor A, "Retrospective evaluation of acute headache in pediatric emergency department : etiologies, red flags, and neuroimaging" 27 : 95-99, 2022

    7 Conti R, "Red flags presented in children complaining of headache in paediatric emergency department" 10 : 366-, 2023

    8 Tsze DS, "Red flag findings in children with headaches : prevalence and association with emergency department neuroimaging" 39 : 185-196, 2019

    9 Lewis DW, "Practice parameter : evaluation of children and adolescents with recurrent headaches : report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society" 59 : 490-498, 2002

    10 Yayici Koken O, "Pediatric headache : are the red flags misleading or prognostic?" 43 : 372-379, 2021

    11 Ravid S, "Obesity in children with headaches : association with headache type, frequency, and disability" 53 : 954-961, 2013

    12 Castro K, "Lifestyle, quality of life, nutritional status and headache in school-age children" 28 : 1546-1551, 2013

    13 Ravid S, "Headache in children : young age at onset does not imply a harmful etiology or predict a harsh headache disability" 28 : 857-862, 2013

    14 Manoyana A, "Diagnostic values of red flags and a clinical prediction score for emergent intracranial lesions in non-traumatic pediatric headaches" 9 : 863-, 2022

    15 Foiadelli T, "Clinical characteristics of headache in Italian adolescents aged 11-16 years : a cross-sectional questionnaire school-based study" 44 : 44-, 2018

    16 Pakalnis A, "Chronic daily headache, medication overuse, and obesity in children and adolescents" 27 : 577-580, 2012

    17 Raucci U, "Children under 6 years with acute headache in Pediatric Emergency Departments : a 2-year retrospective exploratory multicenter Italian study" 43 : 3331024231164361-, 2023

    18 Bu XX, "Association of obesity with headache among US children and adolescents : evidence from NHANES 1999-2004" 13 : 1072419-, 2023

    19 Robberstad L, "An unfavorable lifestyle and recurrent headaches among adolescents : the HUNT study" 75 : 712-717, 2010

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