Primary headache: role of investigations in a cohort of young children and adolescents.
BACKGROUND
We report a study conducted in children and adolescents who are affected by primary headaches. The aim was to establish the most useful investigations for diagnosing headaches.


METHODS
The current study involved 300 consecutively hospitalized children and adolescents selected according to the criteria of the second edition of the International Classification of Headache Disorders. The following examinations were performed in all patients: full ophthalmologic; brain magnetic resonance imaging (MRI); electroencephalography; echocardiogram; and electrocardiogram. Dental, otorhinolaryngology, echocardiography of the supra-aortic trunks, abdominal ultrasound, and visual- and auditory-evoked potentials were carried out in patients according to the clinical signs associated with headache.


RESULTS
In a large number of cases routine laboratory analysis and neurophysiologic investigations were within the normal value when neurologic examination was normal. Electroencephalography, ophthalmologic studies and cerebral MRI are advisable as they can reveal precocious pathologic events, even in the absence of evident or alarming clinical signs.


CONCLUSIONS
As widely reported in the literature, most of these investigations may be of little clinical value, but the authors reasoned that electroencephalography, ophthalmologic investigations and a cerebral MRI may be noteworthy because such studies may reveal a precocious pathologic event which can change the prognostic value of the headache. In addition, negative results on cerebral MRI may relieve the anxiety of parents and in turn may positively influence the clinical course of headache in children and adolescents.
Unit of Pediatrics and Pediatric Emergency, University Hospital Policlinico-Vittorio Emanuele, Department of Pediatrics, University of Catania, Catania, Italy. ppavone@mbox.unict.it
Piero
P
Pavone
Irene
I
Conti
Alice
A
Le Pira
Lorenzo
L
Pavone
Alberto
A
Verrotti
Martino
M
Ruggieri
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D051270:Headache Disorders, Primary / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012189:Retrospective Studies