Clinical Characteristics of Patients Presenting to Child Neurology Outpatient Clinic with Headache: A Single Center Experience

Aim: This study aimed to investigate the clinical and etiological characteristics of children presenting with headache, considering both acute and chronic cases. By distinguishing between primary and secondary headaches, it was aimed to assess the prevalence of underlying pathologies and determine the necessity of further diagnostic evaluations. Material and Methods: The records of 500 patients aged 3-17 years who visited a tertiary pediatric neurology clinic between January 2023 and January 2024 were retrospectively reviewed. Data included age, gender, pain characteristics, associated symptoms, headache subtypes, neuroimaging findings, and treatments. Headaches were classified according to the International Headache Society criteria. Results: Among the patients, 64.8% (n=324) were female. Acute headaches were present in 137 (27.4%) patients, while 363 (72.6%) patients had chronic headaches. Secondary causes were identified in 56.2% (n=77) of acute headaches, most commonly sinusitis (36.5%, n=50) and hypertension (12.4%, n=17). Among primary acute headaches, migraine (23.4%, n=32) and tension-type headache (20.4%, n=28) were the leading diagnoses. Overall, in all 500 patients, migraine (28.6%, n=143) was the most common diagnosis, followed by tension-type headache (27.8%, n=139). Refractive errors and hypertension were observed in 4.6% (n=23). Idiopathic intracranial hypertension was also diagnosed in 0.8% (n=4). Conclusion: Most childhood headaches are primary and manageable with a detailed history and physical examination. However, secondary causes such as sinusitis, hypertension, and nutritional deficiencies should be considered in the differential diagnosis. Neuroimaging and laboratory evaluations are recommended for patients with abnormal findings. Understanding headache etiology can improve diagnosis, management, and quality of life.