Pediatric headache: Are the red flags misleading or prognostic?

• Published in: Brain & development (Tokyo. 1979) 2021-03, Vol.43 (3), p.372-379
• Main Authors: Yayıcı Köken, Özlem, Danış, Ayşegül, Yüksel, Deniz, Aksoy, Ayşe, Öztoprak, Ülkühan, Aksoy, Erhan
• Format: Article
• Language: English
• Subjects: Pediatric headache; Primary headache; Red flags; Secondary headache
• ISSN: 0387-7604; 1872-7131
• DOI: 10.1016/j.braindev.2020.10.007

Symptoms and findings called orange or red flags may indicate the etiology of pediatric headaches and may point to a life-threatening situation requiring urgent treatment and thus can alter patient management. These findings can be either misleading or prognostic for clinicians. We aimed to identify the etiology and prognostic value of orange/red flags in pediatric patients. This study included 810 children with headaches who underwent neuroimaging due to the existence of orange/red flags. Their hospital records were examined to obtain demographical, clinical, laboratory data, and re-classify the headaches and determine orange/red flags on admission. Secondary causes were identified in 17.0% (n: 138) of patients, however, those who were diagnosed with a life-threatening headache that required emergency treatment were 5.2% of all patients and 30.4% of the patients diagnosed with a secondary headache. Those with secondary headaches and with life threatening secondary headaches which required urgent treatment were younger (p = 0,018, p = 0,022), had more emergency department visits (p