Headache in the Pediatric Emergency Service: A Medical Center Experience
Headache in the Pediatric Emergency Service: A Medical Center Experience
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DOI：
10.1016/j.pedneo.2013.09.008
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发表时间：
2014-06-01
影响因子：
2.1
通讯作者：
Wu, Chang-Teng
中科院分区：
文献类型：
--
作者：
Hsiao, Hsiang-Ju;Huang, Jing-Long;Wu, Chang-Teng
背景资料：头痛是儿童常见的主诉，也是儿科急诊科（PED）最常见的原因之一。本研究描述了PED中观察到的头痛患者的病因，并确定了需要紧急干预的颅内病理学（ICP）的预测因素。次要目标是开发快速，实用的工具，用于筛查头痛在PED.Methods：我们进行了回顾性图表审查的儿童谁提出了一个主要投诉头痛在PED在2008年。首先，我们确定了患者病史或体格检查和神经系统检查结果中可能的危险信号。然后，我们记录了脑部计算机断层扫描结果。结果：研究期间，PED就诊43，913次; 409例（0.9%）患者的主要投诉是头痛。急性病毒性、呼吸道和发热性疾病是头痛的最常见原因（59.9%）。6名儿童（1.5%）有危及生命的ICP结果。ICP组视力模糊（p = 0.008）和共济失调（p = 0.002）的发生率明显高于非ICP组。结论：视力模糊和共济失调是预测ICP的最佳临床指标。版权所有（C）2013，台湾儿科医学会.出版社：Elsevier Taiwan LLC All rights reserved.
Background: Headache is a common complaint in children and is one of the most common reasons for presentation at a pediatric emergency department (PED). This study described the etiologies of patients with headache seen in the PED and determined predictors of intracranial pathology (ICP) requiring urgent intervention. A secondary objective was to develop rapid, practical tools for screening headache in the PED.Methods: We conducted a retrospective chart review of children who presented with a chief complaint of headache at the PED during 2008. First, we identified possible red flags in the patients' history or physical examination and neurological examination findings. Then, we recorded the brain computed tomography results.Results: During the study period, 43,913 visits were made to the PED; in 409 (0.9%) patients, the chief complaint was headache. Acute viral, respiratory, and febrile illnesses comprised the most frequent cause of headache (59.9%). Six children (1.5%) had life-threatening ICP findings. In comparison with the group without ICP, the group with ICP had a significantly higher percentage of blurred vision (p = 0.008) and ataxia (p = 0.002).Conclusion: Blurred vision and ataxia are the best clinical parameters to predict ICP findings. Copyright (C) 2013, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved.