What is the morbidity and mortality associated with pediatric headache?

Updated: Jan 02, 2019
  • Author: J Ivan Lopez, MD, FAAN, FAHS; Chief Editor: George I Jallo, MD  more...
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No mortality is associated with primary headaches, and that associated with secondary headaches depends purely on the underlying cause.

However, frequent headaches, as with other chronic pain syndromes, can be psychologically distressing and may have major implications on the life of the growing individual. According to Battistutta et al, chronic tension-type headache is comorbid with psychiatric illnesses such as depression and anxiety disorders, internalization syndrome, and attention deficit and anger-control deficit in adolescents. However the relationship between the psychological condition and the headache syndrome is far from simple and has not yet been resolved. The clinical implication is to attend to the entire symptomatology of the child. [31]

Migraine in general, but especially migraine with aura (any type [typical aura, hemiplegic migraine, basilar migraine]), seems to be associated with a slightly increased risk of ischemic stroke, but overall, the risk remains very low. The stroke risk is further magnified, however, in women, patients younger than 45 years, smokers, and persons using oral contraceptives. [32]

Other conditions comorbid with migraine have been observed, including irritable bowel syndrome, sleep disorders, bruxism, systemic lupus erythematosus, and obesity. [33]

Reports have indicated a higher incidence of ataxia associated with migraine, whether clinical or subclinical during provocation tests. These reports could correlate with white matter lesions on magnetic resonance imaging (MRI), especially in the cerebellum.

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