Abstract

Background
To assess the utility of neuroimaging study in evaluation of children and adolescents with recurrent head- ache. Methods: We retrospectively reviewed medical records and neuroimages of patients with recurrent headache who visited the pediatric neurologic clinic at Kangnam Sacred Heart Hospital between January 2004 and June 2006. The diagnostic criteria of International Classification of Headache Disorders II were used in the classification of patient. Results: We included 164 children with a mean age of 9.1±2.9 years. There were 136(82.9%) patients with primary headache and 27(17.1%) patients with secondary headache. Of patients with primary headache, there were 41(30.2%) patients with migraine without aura, 21(15.4%) patients were migraine with aura, 43(31.6%) patients were episodic tension-type headache, and 31(22.8%) patients were chronic daily headache. Of the 136 patients with primary headache, 110(81.9%) were normal and 26(19.1%) showed benign abnormal findings. Abnormal findings included 14 cases of sphenoidal sinusitis, 4 cases of arachnoid cyst, 3 cases of leukomalacia, 2 cases of venous angioma, 2 cases of pineal cyst, and 1 case of sinus polyp. All the benign cases required no surgical treatment. Of the 28 patients with secondary headache, 23(82%) were showed benign abnormal finding. Benign abnormal findings included 16 cases of sphenoidal sinusitis, 2 cases of arachnoid cyst, and 1 case of hydrocephalus. There were 4 cases of sinister finding. 1 case of intracranial hemorrhage, 1 case of AV malformation, 1 case of craniopharyngioma, 1 case of Rathke's pouch cyst and all the cases required surgical treatment. Of 164 patients with recurrent headache, 49(29.8%) patients showed abnormal findings in neuroimaging study and 4(2.43%) cases were sinister. Duration of headache was found to have statistically significant association with neuroimaging finding with sinister disease. Conclusion: About 30% of pediatric patients with recurrent headache have abnormal findings, which included 2.4% sinister findings.