title: Headache in children with sickle cell disease: prevalence and associated factors.
abstract: OBJECTIVE
  To compare the prevalence of frequent headache in children with sickle cell disease (SCD) to that of black control subjects and to assess factors associated with headache in SCD.
  
  
  METHODS
  In this cross-sectional study, a headache questionnaire was administered to subjects with SCD and black control subjects. Subjects answered supplementary questions about SCD complications. Clinical and radiographic information were abstracted from medical charts for subjects with SCD.
  
  
  RESULTS
  Children (n = 241) with SCD and 141 control subjects were studied; 32.4% (95% CI 26.5%-38.7%) of subjects with SCD reported having headaches at least weekly, similar to control subjects at 27% (95% CI 19.8%-35.1%, P = NS); however, in children <13 years, headache was more common in subjects with SCD than in control subjects (24% vs 9.7%, P = .013). The prevalence of headache was similar among the different SCD genotypes. Factors associated with frequent headaches in subjects with SCD included older age, frequent vaso-occlusive pain episodes, symptoms of obstructive sleep apnea, and cerebral vessel stenosis detected by magnetic resonance angiography.
  
  
  CONCLUSIONS
  The prevalence of headaches in children with SCD is similar to the general population; however, younger children with SCD report headaches more frequently than control subjects. The cause of headache is likely multifactorial, and SCD-specific factors may contribute.
authors.affiliation: Duke University School of Medicine, USA.
authors.forename: Alison E
authors.initials: AE
authors.lastname: Niebanck
authors.forename: Avrum N
authors.initials: AN
authors.lastname: Pollock
authors.forename: Kim
authors.initials: K
authors.lastname: Smith-Whitley
authors.forename: Leslie J
authors.initials: LJ
authors.lastname: Raffini
authors.forename: Robert A
authors.initials: RA
authors.lastname: Zimmerman
authors.forename: Kwaku
authors.initials: K
authors.lastname: Ohene-Frempong
authors.forename: Janet L
authors.initials: JL
authors.lastname: Kwiatkowski
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000704:Analysis of Variance; D000755:Anemia, Sickle Cell / Q000175:diagnosis / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006261:Headache / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000175:diagnosis / Q000453:epidemiology; D010147:Pain Measurement; D015995:Prevalence; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution