Background

Adult abrupt severe non-traumatic headache (thunderclap) is often related to serious underlying etiologies such as subarachnoid hemorrhage. However, data are sparse regarding thunderclap headache in the pediatric population.

Objective

The aim of the study was to evaluate the prevalence, characteristics and causes of thunderclap headache in the pediatric and adolescent population, aged 6–18 years, presenting to a pediatric emergency department.

Methods

The electronic database of a tertiary care pediatric emergency department was searched for children presenting with acute headache during 2016–2018. Headache severity was defined by pain scales, either a visual analogue scale or by the Faces Pain Scale–Revised.

Results

Thunderclap headache was diagnosed in 19/2290 (0.8%) of the included patients, all of them with a pain score of 10/10. All the patients had a benign course. Primary headache was diagnosed in 15/19 (78.9%), six patients had migraine and eight were diagnosed with primary thunderclap headache. Four of the 19 patients were diagnosed with secondary headache: three with infectious causes and one with malignant hypertension.

Conclusions

Thunderclap headache is rare among children and adolescents presenting to the emergency department. This headache is generally of a primary origin. Extensive evaluation is still needed to rule out severe diagnosis problems.

中文翻译：

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儿科急诊科的严重突发（霹雳）非创伤性头痛——一项回顾性研究

背景

成人突发性严重非创伤性头痛（雷击）通常与严重的潜在病因有关，例如蛛网膜下腔出血。然而，关于儿科人群中霹雳样头痛的数据很少。

客观的

该研究的目的是评估 6-18 岁的儿科和青少年人群中霹雳样头痛的患病率、特征和原因，并就诊于儿科急诊科。

方法

在三级护理儿科急诊科的电子数据库中搜索了 2016-2018 年期间出现急性头痛的儿童。头痛严重程度由疼痛量表定义，视觉模拟量表或面部疼痛量表修订版。

结果

19/2290 (0.8%) 的纳入患者被诊断为霹雳样头痛，所有患者的疼痛评分均为 10/10。所有患者均为良性病程。15/19 (78.9%) 被诊断为原发性头痛，6 名患者患有偏头痛，8 名患者被诊断为原发性霹雳样头痛。19 名患者中有 4 人被诊断为继发性头痛：3 人为感染性原因，1 人为恶性高血压。

结论

在急诊科就诊的儿童和青少年中很少见霹雳样头痛。这种头痛通常是原发性的。仍然需要进行广泛的评估以排除严重的诊断问题。