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Neuroimaging in Pediatric Headache
Aline Camargo1, Sangam Kanekar1
1Radiology Research, Division of Neuroradiology, Penn State Health, Penn State College of Medicine, Mail Code H066 500 University Drive, Hershey, PA 17033, USA.
Insights
Pediatric headaches are common, affecting over half of children and leading to frequent medical visits. While most headaches aren't serious, doctors use clinical history and exams, reserving neuroimaging for specific warning signs.
Area of Science:
- Pediatric Neurology
- Clinical Medicine
Background:
- Headaches are a prevalent childhood disorder, accounting for nearly 500,000 physician and emergency department visits annually.
- Estimated pediatric headache prevalence is 58.4%, though actual incidence may be higher due to underreporting of cases not seeking medical attention.
Purpose of the Study:
- To outline the diagnostic approach for headaches in children.
- To clarify when neuroimaging is indicated in pediatric headache evaluations.
Main Methods:
- Clinical history taking and physical examination are the primary diagnostic tools.
- Review of guidelines from the American Academy of Neurology (AAN) and American College of Radiology (ACR) regarding neuroimaging in pediatric headache.
Main Results:
- Primary headaches in children generally do not require neuroimaging, according to AAN and ACR recommendations.
- Neuroimaging is indicated when "red flags" suggesting a secondary cause are present.
Conclusions:
- A thorough clinical evaluation is the cornerstone for diagnosing pediatric headaches.
- Neuroimaging should be reserved for cases with specific "red flags" to efficiently rule out serious underlying conditions.
Abstract:
Headache represents one of the most common disorders in childhood and leads to nearly half a million visits to the physician's office or emergency department every year. Although the estimated prevalence is around 58.4%, the actual incidence of headache in the pediatric population might be underestimated, given only a percentage of cases seek medical attention. The first step in the evaluation of pediatric headache is a detailed clinical history and relevant clinical examinations. AAN and ACR do not recommend neuroimaging for patients with primary headache. However, neuroimaging becomes mandatory in presence of red flags to rule out the underlying cause.
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