Özet:

Objective Headache is a common complaint in childhood. While the etiology is usually benign, such as migraine or tension-type headache, cranial imaging is often performed on patients to identify any missed or serious underlying pathology. In the present study we assess the etiology and clinical characteristics of headaches in children and establish the diagnostic contribution of imaging methods. Material and Method This retrospective study included patients who presented with headaches to the Pediatric Neurology Outpatient Clinic of Süleyman Demirel University Faculty of Medicine between 2019 and 2022. Headache information (frequency, duration, type, characteristics, intensity, localization, and accompanying findings) was obtained, and the cranial imaging results of patients were recorded. Headaches were classified according to the criteria established by the International Headache Society. Results The study included 234 patients aged 2–18 years with a mean age of 12.56 years, of which 64.5% were female. The diagnosis was primary headaches in 68.4% of the patients, with tension-type headaches in 46.2%, migraine in 31.2%, and other primary headache causes in 22.5%. Among the secondary headaches, disorders of the cranium, neck, eyes, ears, nose, sinuses, teeth or other cervical structures accounted for 79.7%, with the most common cause being sinusitis. Cranial imaging was performed on 66.7% of the patients, of which 51.9% were identified with abnormal findings. 14.1% of the imaging results evaluated as abnormal were incidentally detected cerebral abnormalities with potential clinical significance; 10.3% were findings that were found incidentally and had no clinical significance. The treatment of these patients did not change with the imaging result. Another 25% were evaluated as extracerebral abnormality associated with headache. Only one patient's outcome was associated with headache. The patient was diagnosed with sinus vein thrombosis and the treatment was arranged. Conclusion The majority of childhood headaches identified in the present study were found to be benign, with the leading causes being tension-type headache, infection and migraine, and imaging methods were found to be of little diagnostic benefit. It was concluded that a detailed clinical assessment of patients presenting with headaches could clarify the etiology, while imaging methods may be useful in selected cases.

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