title: Headache in the pediatric emergency service: a medical center experience.
abstract: BACKGROUND
  Headache is a common complaint in children and is one of the most common reasons for presentation at a pediatric emergency department (PED). This study described the etiologies of patients with headache seen in the PED and determined predictors of intracranial pathology (ICP) requiring urgent intervention. A secondary objective was to develop rapid, practical tools for screening headache in the PED.
  
  
  METHODS
  We conducted a retrospective chart review of children who presented with a chief complaint of headache at the PED during 2008. First, we identified possible red flags in the patients' history or physical examination and neurological examination findings. Then, we recorded the brain computed tomography results.
  
  
  RESULTS
  During the study period, 43,913 visits were made to the PED; in 409 (0.9%) patients, the chief complaint was headache. Acute viral, respiratory, and febrile illnesses comprised the most frequent cause of headache (59.9%). Six children (1.5%) had life-threatening ICP findings. In comparison with the group without ICP, the group with ICP had a significantly higher percentage of blurred vision (p = 0.008) and ataxia (p = 0.002).
  
  
  CONCLUSIONS
  Blurred vision and ataxia are the best clinical parameters to predict ICP findings.
authors: Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors: Hsiang-Ju
authors: HJ
authors: Hsiao
authors: Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors: Jing-Long
authors: JL
authors: Huang
authors: Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors: Shao-Hsuan
authors: SH
authors: Hsia
authors: Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors: Jainn-Jim
authors: JJ
authors: Lin
authors: Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors: I-Anne
authors: IA
authors: Huang
authors: Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: wct0722@gmail.com.
authors: Chang-Teng
authors: CT
authors: Wu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D005334:Fever / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D006261:Headache / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D010372:Pediatrics / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014777:Virus Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy
keywords: children; computed tomography; emergency department; headache