Journal of Pediatric Neurology
DOI: 10.1055/s-0040-1721460
Original Article

Reassessment of Pediatric Tension-Type Headaches

1  Department of Otorhinolaryngology—Head and Neck Surgery, Assaf Harofeh Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel
,
2  Emergency Department, Crimean Republican Center for Disaster Medicine and Emergency Medical Aid, Simferopol, Russia
,
3  Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated with Alexander Muss Institute for Israel Education (AMIIE), Hod HaSharon, Israel
,
4  Department of Oral and Maxillofacial Surgery, Barzilai Medical Center, Ashkelon, Israel
,
5  Department of Pediatrics, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
,
3  Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated with Alexander Muss Institute for Israel Education (AMIIE), Hod HaSharon, Israel
6  Department of Advanced Research and Design, Milken Community High School, Los Angeles, California, United States
,
3  Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated with Alexander Muss Institute for Israel Education (AMIIE), Hod HaSharon, Israel
6  Department of Advanced Research and Design, Milken Community High School, Los Angeles, California, United States
,
7  Department of Internal Medicine #2, V.I. Vernadsky Crimean Federal University, Simferopol, Russia
,
3  Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated with Alexander Muss Institute for Israel Education (AMIIE), Hod HaSharon, Israel
› Author Affiliations

Abstract

A retrospective multicenter chart review was conducted with the objective of evaluating the hypothesis that certain cases diagnosed as tension-type headache (TTH) in pediatric neurology are not stress-related or central sensitization-related conditions but may mimic an autoimmune disorder of the dura mater. Of the 29,642 patient charts reviewed, 12,424 charts (42%) were excluded because of incomplete data and 17,218 cases were analyzed. For all the 29,642 charts, TTH or chronic daily headaches were diagnosed in 29.2% of cases. Among the 17,218 cases subjected to detailed diagnostic procedures, TTH was diagnosed in only 5%. In 7,044 cases, the initial diagnosis of TTH was changed to headache attributed to infection (87.4%), which was supported by the presence of meningeal signs, high antistreptolysin-O titers, and, in 46% of cases, magnetic resonance imaging (MRI)-detected thickening of the cranial dura mater. The initial diagnosis of migraine was confirmed in 87.7% of cases (8,034/9,162). In some cases of treatment-resistant pediatric recurrent headaches, which are initially diagnosed as TTH, a secondary type of headache may be suspected as the underlying cause. Usually this type of headache has streptococcal infection-related laboratory findings, the meninges as the site of the lesion, and meningism as the clinical presentation.



Publication History

Received: 18 May 2020

Accepted: 12 August 2020

Publication Date:
02 December 2020 (online)

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