Short lasting activity-related headaches with sudden onset in children a case-based reasoning on classification and diagnosis 英文参考文献.docVIP

Toldoetal.TheJournalofHeadacheandPain2013,14:3 /content/14/1/3 SHORT REPORT OpenAccess Shortlastingactivity-relatedheadacheswith suddenonsetinchildren:acase-basedreasoning onclassificationanddiagnosis IreneToldo1*,DeboraDeCarlo1,RodicaMardari2,LucaDePalma1,MichelaGatta1,BarbaraBolzonella1, MargheritaNosadini1,LucaBartolini1,StefanoSartori1andPierAntonioBattistella1 Abstract Background:Shortlastingheadachesrelatedtoactivityorcougharerare,particularlyinchildhood,andcanbe difficulttodiagnose,especiallyinyoungchildrenwhoarenotabletodescribetheirsymptoms.Intheliterature therearefewdataonthistopicinadultsandthepaediatriccasesreportedareevenmorerare. Findings:Wepresenttheclinicalhistoryofa7-year-oldchildanda3-year-oldchildbothdiagnosedashaving activity-relatedheadaches,characterizedbysuddenonsetofshortlasting(fewseconds)attacks,thatweretriggered bycoughorexercise.Therewerenoaccompanyingsymptomsandtheneurologicalexaminationwasnormalin bothcases.Brainmagneticresonanceimagingshowed,inthefirstcase,acerebellarpilocyticastrocytomaand,in thesecondcase,aChiari1malformation.Bothcasesreceivedanearlydiagnosis,weresurgicallytreatedandhada goodprognosisatfollow-up. Conclusions:Whenheadachehasarecentonset,itpresentssuddenly,anditistriggeredbystrain,evenwith normalneurologicalexamination,neuroimagingismandatoryinordertoexcludesecondaryheadaches,especially inchildren. Keywords:Children,Coughheadache,Exertionalheadache,Secondaryheadaches,Chiari1malformation Introduction We describe the history of two children with activity- Primary cough headache and primary exertional head- related headaches in which a diagnosis of secondary ache, included respectively in paragraph 4.2 and 4.3 of headachewasmade.Theclinicalstudieswereconducted the current International Classification of Headache accordingtoroutinelyadoptedprotocolsapprovedfrom Disorders(ICHD-II,2004)[1],arerareinadults[2-11], the local ethics committee. We discuss the possible dif- but especially in children [4]. Recently some A