HPPŠ HEADACHES IN CHILDERN - CLINICAL AND DIAGNOSTICAL CHARACTERISTICS
I. Prpić, O. Mladinov, E. Paučić-Kirinčić, I. Vlašić-Cicvarić, A. Sasso, Z. Modrušan-Mozetič
Headache is one of the most painful symptom in children and one of the most common reasons for seeking professional help. There are various headache classifications but for every day practice the most appropriate is that of acute, acute recurrent, chronic progressive, chronic non-progressive and mixed type of headache. Migraine is one of the most common type of childhood headache. It has been described already in 2 years old children. Its characteristic is pulsating headache accompanied with nausea and vomiting. Furthermore, various well-defined migraines syndromes or variants are defined which require detailed neurodiagnostic evaluation before diagnosis is established. Contrary, diagnosis of migraine is based on history and patients follow-up. Non-migrenuous type of headache include tension type (chronic non-progressive headache), not so well investigated in children. These types of headache in children usually reflect psychosomatic disorders. Headache, which is worsening in time, accompanied with additional symptoms as vomiting, nausea or neurological changes should always raise suspicion of expansive intracranial process. Post-traumatic headache is extremely rare in children. Principal examination in children and adolescent with headache and base for further diagnostic procedure is headache history. Any changes in neurological examination, no matter of headache type needs additional evaluation by child neurologist and neuroimaging evaluation. Basic and necessary measure in children headache are history, general and neurological examination, routine laboratory analyses, ophtalmological and ENT examination and psychological evaluation. However, despite any recommendation if there is any suspicion in physician mind regarding child with headache any measure and diagnostic procedure is appropriate.