Retrospective Evaluation of Patients Admitted to the Pediatric Neurology Outpatient Clinic with Headache: Experience of a Tertiary Hospital

Objectives: It was aimed to determine the etiological and clinical features of pediatric patients with headache complaints. Methods: The files of patients who were admitted to the pediatric neurology outpatient clinic with headache were reviewed retrospectively. Patients' age, gender, features of headache, symptoms accompanying headache, available blood tests, brain magnetic resonance (MR) and electroencephalography (EEG) results were recorded.
Results: Of the total 470 patients, aged between 3 and 17 years, 291 (61.9%) were female and 179 (39.1%) were male. The mean age of the patients was 12.38±3.45 years. According to age groups, there were 16 (3.4%) patients under the age of 5, 159 (33.8%) between the ages of 6-11, and 295 (62.8%) patients aged 12-17 years. While 289 (61.5%) patients were diagnosed with primary headache, 122 (26.0%) patients were diagnosed with secondary headache, and headaches of 59 (12.5%) patients could not be classified. The most common primary headaches were tension-type headache (TTN) (n=177, 37.7%) and migraine (n=111, 23.6%). The 86 (70.5%) of the patients with secondary headache were diagnosed with sinusitis. Abnormal neurological examination finding was determined in 8 (1.7%) patients. Brain MR was performed in 439 (93.4%) of all patients and abnormal brain MR findings were detected in 52 (11.8%) patients. EEG was performed in 205 (43.6%) of all patients and abnormal EEG findings were detected in 24 (11.7%) patients.
Conclusion: According to age groups, headache was most common in the 12-17 age group. The most common causes of headache were TTN and migraine, respectively. The most common secondary headache cause was sinusitis. We think that physical and neurological examination still maintains its priority in determining the causes of headache.

Çocuk Nörolojisi Polikliniðine Baþ Aðrýsý ile Baþvuran Hastalarýn Retrospektif Olarak Deðerlendirilmesi: Üçüncü Basamak Hastane Deneyim

Amaç: Baþ aðrýsý yakýnmasý olan çocuk hastalarýn etyolojik ve klinik özelliklerini belirlemek amaçlandý.
Yöntem: Çocuk nöroloji polikliniðine baþ aðrýsý þikayeti ile baþvuran hastalarýn dosyalarý retrospektif olarak incelendi. Hastalarýn yaþý, cinsiyeti, baþ aðrýsýnýn özellikleri, baþ aðrýsýna eþlik eden semptomlar, mevcut kan tetkikleri, beyin manyetik rezonans (MR) ve elektroensefalografi (EEG) sonuçlarý kaydedildi.
Bulgular: Yaþlarý 3-17 yýl arasýnda deðiþen toplam 470 hastanýn 291'i (%61,9) kadýn, 179'u (%39,1) erkekti. Hastalarýn yaþ ortalamasý 12,38 ± 3,45 yýl idi. Yaþ gruplarýna göre 5 yaþ altý 16 (%3,4), 6-11 yaþ arasý 159 (%33,8), 12-17 yaþ arasý 295 (%62,8) hasta vardý. 289 (%61,5) hastaya primer baþ aðrýsý tanýsý konulurken, 122 (%26,0) hastaya sekonder baþ aðrýsý tanýsý kondu ve 59 (%12,5) hastanýn baþ aðrýsý sýnýflandýrýlamadý. En sýk görülen primer baþ aðrýlarý gerilim tipi baþ aðrýsý (GTB) (n: 177, %37,7) ve migren (n: 111, %23,6) idi. Sekonder baþ aðrýsý olan hastalarýn 86'sýna (%70,5) sinüzit tanýsý kondu. Sekiz (%1,7) hastada anormal nörolojik muayene bulgusu saptandý. Tüm hastalarýn 439'una (%93,4) beyin MR çekildi ve 52 (%11,8) hastada anormal beyin MR bulgusu saptandý. Tüm hastalarýn 205'ine (%43,6) EEG çekildi ve 24 (%11,7) hastada anormal EEG bulgusu saptandý.
Sonuç: Yaþ gruplarýna göre, baþ aðrýsý en sýk 12-17 yaþ grubunda görüldü. Baþ aðrýsýnýn en yaygýn nedenleri sýrasýyla GTB ve migrendi. En yaygýn ikincil baþ aðrýsý nedeni sinüzitti. Baþ aðrýsý nedenlerinin belirlenmesinde fizik ve nörolojik muayenenin hala önceliðini koruduðunu düþünüyoruz. (SETB-2023-08-132)