CAUSE PAIN HEAD (HEADACHE)

Secondary Headache
       Among the various causes of secondary headache , the most important is the headache caused by a brain tumor and headache due to meningitis .
       Headache due to elevation of intracranial pressure and / or hydrocephalus caused by a brain tumor . Based on its location , brain tumors can occur supratentorial or infratentorial . Supratentorial tumors showed symptoms of headache , paralysis and seizures , whereas infratentorial tumors is often accompanied by symptoms of brain nerves and cerebellar symptoms . The analysis of 200 children with brain tumors showed symptoms of headache ( 41 % ) , vomiting ( 12 % ) , the imbalance ( 11 % ) , visual disturbances ( 10 % ) , conduct disorder ( 10 % ) and seizures ( 9 % ) . Examination reveals papilledema ( 38 % ) , cranial nerve disorders ( 49 % ) , cerebellar disorders ( 48 % ) , disability ( 27 % ) and loss of consciousness ( 12 % ) .
       Headache due to brain tumor usually is not pulsed , is progressive becoming more and more frequent and more severe . Often accompanied by vomiting . Its location is often settled in the area . Pain often occurs in the morning when you wake up , and aggravated by Valsalva maneuvers such as coughing , sneezing , or straining . Pain is also aggravated by physical activity .
        Headache for central nervous system infections , especially meningitis . In bacterial meningitis , characterized headache symptoms of infection , symptoms of excitatory meningeal and cerebral symptoms such as seizures or paralysis .
         Head Pain in Children and Adolescents . Big boy with tuberculous meningitis may show symptoms of severe headache before the appearance of symptoms of other cerebral and meningeal symptoms stimuli . In contrast to other intracranial pressure elevation , in tuberculous meningitis often found atrophy of the optic disc N. II because the nerves to the brain II directly affected . Symptoms similar to a brain abscess brain tumor plus symptoms of infection .
        Posttraumatic headache . Posttraumatic headache pain can be an acute or chronic pain . Acute pain can occur after a trauma that causes mild or severe trauma berat.25 trauma can cause brain hemorrhage , subdural or epidural hemorrhage . Headache after trauma usually is part of a post- traumatic syndrome that includes dizziness , difficulty concentrating , anxiety , personality changes and insomnia .
This article is taken from the website : INDONESIA Pediatric Association ( idai.or.id ) . thank you

headache in children and teens

Tension - type headache ( TTH )
        Previously thought to be caused by psychological factors that TTH , but in fact it is essentially neurobiological . TTH TTH divided into infrequent episodic , frequent episodic TTH and chronic TTH . Each of these circumstances can be with or without accompanying pain perikranial .In children it is often difficult to distinguish TTH to migraine . In TTH diagnosis , some exclusion criteria for migraine is a factor . TTH does not indicate that throbbing pain , not unilateral , do not become more severe when the move , and autonomic symptoms such as nausea and vomiting .
Pathophysiology
         TTH is not yet known . Chronic type may be the result of central mechanisms whereas episodic type is due to peripheral mechanisms . Infrequent episodic type usually does not cause serious problems , but often episodic and chronic type often cause significant disruption to the child .The presence of pain in the muscle emphasis perikranial very helpful diagnosis . Pain increases with the intensity and frequency of headache . Emphasis is made ​​with the index finger and middle finger in a circular motion on the frontal muscle , temporal , masetter , pterygoid , splenius and trapezius .Frequent episodic TTH and chronic TTH may coexist with migraine without aura . Both of these situations should be distinguished because the natural course of the disease berbeda.Dalam treatment , migraine can be turned into TTH .
Cluster headache
          Appears as unilateral pain in the orbital , supraorbital , temporal or in combination . The attack lasts 15-180 minutes and occur once two days to 8 times per day . Attacks accompanied by symptoms such as unilateral conjunctival injection , lacrimation , nasal congestion , rhinorrhea , forehead and facial sweating on , miosis , ptosis , eyelid edema and large mata.Sebagian patients showed agitation during the attack . Cluster headache is rare in children , onset is most frequent in the age over 20 years .
This article is taken from the website : INDONESIA Pediatric Association ( idai.or.id ) . thank you

Migraine and How to treat of Migraine

         In children , migraine can be showed manifestations in several forms, migraine without aura (common migraine ) , migraine with aura ( classic migraine ) , and periodic syndrome which is a precursor of migraine in adolescents migren.8 will settle in 41.8 % of cases , experience remission in 38.2 % of cases and turn into TTH in 20 % of cases .
Migraine without aura
        Is a type of migraine is most commonly found . His trademark is a headache with symptom -free intervals . Headache was throbbing , which is sometimes difficult to explain to a child . Migraines accompanied by autonomic symptoms such as nausea and vomiting , and aggravated by physical activity . Symptoms of nausea and vomiting have also caused significant disruption activity .
        For a child has made ​​modifications to the diagnostic criteria , namely : between 1-72 hours long attack , the location of bilateral or bifrontal at age less than 15 years with a record of when the occipital location to look for other possible causes , and the presence of photophobia and phonophobia were seen with changes in behavior , for example go into a dark room and sepi.Adanya provisions " not caused by something else " suggests that other diagnoses must be ruled out .

Migraine with aura
           Aura symptoms caused depolarization of neurons in one place and oligaemia accordance with the theory of cortical spreading depression . Visual aura is a disorder that is often found with bilateral visual acuity scotoma ( 77 % ) , distortion or hallucinations ( 16 % ) and impaired vision monocular or scotoma ( 7 % ) .
Abdominal migraines
           This situation may be common, but rarely diagnosed . Can be regarded as a refusal to go to school . The key is to know him repeating patterns , and get rid of gastrointestinal and renal diseases .
Therapy on Migraines
         The goal of management is a long-term comprehensive management to reduce the frequency , weight and length of the attack ; provide the best therapy ; prevent excessive treatment , and improving the quality of life of patients .
        Drug therapy in migraine can be divided into therapies to treat acute attacks and prophylactic therapy to prevent attacks . Many drugs can be used in adults has not been granted permission for use in children so that their use is still off - label . In addition , the many known migraine complementary and alternative therapies , such as psychological interventions , lifestyle changes , relaxation , bio - feedback , diet and others.
        Therapy of acute migraine attacksThe goal of acute treatment is to eliminate pain and other symptoms quickly and effectively so that patients can return to work . Drugs should be given when the patient begins to feel any symptoms . When symptoms of migraine has reached its peak , the treatment becomes very difficult . Mild attacks only require one kind of analgesics while heavy attacks require combination therapy .

This article is taken from the website: INDONESIA Pediatric Association (idai.or.id). thank you

Classification of Headache (Headache)

       Headache is a very common complaint in children and adolescents . Often doctors are confused face of the complaint and then solve the problem by performing imaging studies and EEG , which is not appropriate because most of the results indicate that the norm .

Epidemiology
       Data from retrospective studies showed that headache " generic " was found in 37-51 % of children aged 7 years , and increased to 57-82 % of children aged 15 years . Among all headaches in children , migraine and tension - type headache ( TTH ) showed the highest prevalence . The prevalence of migraine was 3 % in pre-school children , 4-11 % of primary school aged children , and 8-23 % in secondary school, while the prevalence of TTH is 30-78 %.

Classification of headache
       Classification of headache have been published by the International Headache Society with the revision in the classification 2005.Dalam , headache diagnosis number in the tens of sorts .
      Headache can be divided into primary headache consisting of migraine , tension - type headache (TTH ), cluster headaches and secondary headaches are caused by other diseases . Among the many types of headache , which is important for pediatricians are migraine , tension - type headache and secondary headache due to intracranial infection , intracranial mass and head trauma .

Some types of headache are important, namely:
1. Migraine
2. Migraine without aura
3. Migraine with aura
4. Benign paroxysmal vertigo
5. periodic syndrome
6. cyclic vomiting
7. abdominal migraines
8. Tension-type headache (TTH)
  9. cluster headache
10. Secondary Headache

This article is taken from the website: INDONESIA Pediatric Association (idai.or.id). thank you