[Primary headaches in children with hydrocephalus who have a ventriculoperitoneal bypass valve].
BACKGROUND
Headache, which is the clinical manifestation of intracranial hypertension, is also a clinical ailment in medical practice, as well as one of the main causes of visits in the paediatric age. Determining whether this symptom is secondary or not to a decompensation of the intracranial pressure in children with hydrocephalus is sometimes a challenging task. The aim of this study is to classify the headaches in a population of children with a ventriculoperitoneal bypass valve due to hydrocephalus.


METHODS
We conducted a study of a series of cases with a longitudinal follow-up. 20 children with a ventriculoperitoneal bypass valve owing to hydrocephalus were followed up over a mean period of eight months because they suffered from recurring headaches. All of them answered a questionnaire in order to define the characteristics of their headache. Those who were suspected of suffering from intracranial hypertension were submitted to a cerebral tomography study.


RESULTS
In all, we studied 20 patients (eight males and 12 females) with a mean age of 8.6 +/- 2.8 years. Hydrocephalus was secondary to abnormalities in the craniocervical transition and myelomeningocele in all cases. The aetiology of the headache was primary migraine-type headache (14 patients; 70%), and tension-type headache (two patients; 10%). Secondary headaches appeared in four patients (20%) due to acute sinusitis, refraction errors and systemic infection; only one patient had headache due to intracranial hypertension.


CONCLUSIONS
Migraine predominates as the primary headache in children with bypass valves--a phenomenon that can be explained by its high prevalence in the paediatric population.
Matta
A Palma-da Cunha
AP
Centro de Rehabilitación Infantil Evandro Carlos de Andrade, Río de Janeiro, Brazil.
Carod-Artal
F J
FJ
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006261:Headache / Q000145:classification / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000503:physiopathology*; D008297:Male; D011795:Surveys and Questionnaires; D017287:Ventriculoperitoneal Shunt