title: Seasonal Variation in Emergency Department Visits Among Pediatric Headache Patients.
abstract: OBJECTIVE
  To ascertain whether seasonal variation occurs in emergency department (ED) visits for headache among children and adolescents.
  
  
  METHODS
  A retrospective review was conducted using the electronic medical records of ED visits for headache at a tertiary children's hospital through calendar years 2010-2014. Using ICD-9 diagnostic codes for headache and migraine, the numbers of headache visits were determined and compared by season and during school months vs summer months.
  
  
  RESULTS
  A total of 6572 headache visits occurred. Headache visits increased during the fall season (133 ± 27 visits per month) compared with other seasons (101 ± 19 visits per month), P ≤ .002, but did not differ when comparing school months (113 ± 25 visits per month) and summer months (100 ± 24 visits per month), P = .1.
  
  
  CONCLUSIONS
  The corresponding increase in ED visits during the fall season coincides with the start of the school year. Academic stressors and the change in daily schedule may lead to more headaches and more ED headache visits among school-aged youth.
authors.affiliation: Section of Pediatric Neurology, Nationwide Children's Hospital, Columbus, OH, USA.|Departments of Neurology and Pediatrics, the Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: A
authors.initials: A
authors.lastname: Pakalnis
authors.affiliation: Section of Pediatric Neurology, Nationwide Children's Hospital, Columbus, OH, USA.|Departments of Neurology and Pediatrics, the Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: G L
authors.initials: GL
authors.lastname: Heyer
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006261:Headache / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012574:Schools; D012621:Seasons; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D014481:United States
keywords: emergency department; headache; migraine; pediatric; seasonal