Cefalea en urgencias pediátricas, clínica y signos de alarma
La cefalea en los niños es un motivo de consulta frecuente, del cual se conoce el aumento de frecuencia en todas las edades pediátricas. En nuestro medio se desconocen las características clínicas de los pacientes y el uso de medios diagnósticos. Objetivo: Establecer las características clínicas en...
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- 2016
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- Universidad Militar Nueva Granada
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- Repositorio UMNG
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- spa
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- oai:repository.unimilitar.edu.co:10654/7299
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- Palabra clave:
- Cefalea
Pediatría
Urgencias
Neuroimágenes
CEFALALGIA
URGENCIAS PEDIATRICAS
Headache
Pediatrics
Emergency
Neuroimaging
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- http://purl.org/coar/access_right/c_abf2
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| dc.title.spa.fl_str_mv |
Cefalea en urgencias pediátricas, clínica y signos de alarma |
| dc.title.titleenglish.spa.fl_str_mv |
Headache in pediatric emergency room, clinic and warning signs |
| title |
Cefalea en urgencias pediátricas, clínica y signos de alarma |
| spellingShingle |
Cefalea en urgencias pediátricas, clínica y signos de alarma Cefalea Pediatría Urgencias Neuroimágenes CEFALALGIA URGENCIAS PEDIATRICAS Headache Pediatrics Emergency Neuroimaging |
| title_short |
Cefalea en urgencias pediátricas, clínica y signos de alarma |
| title_full |
Cefalea en urgencias pediátricas, clínica y signos de alarma |
| title_fullStr |
Cefalea en urgencias pediátricas, clínica y signos de alarma |
| title_full_unstemmed |
Cefalea en urgencias pediátricas, clínica y signos de alarma |
| title_sort |
Cefalea en urgencias pediátricas, clínica y signos de alarma |
| dc.contributor.advisor.none.fl_str_mv |
Espinosa Garcia, Eugenia |
| dc.subject.spa.fl_str_mv |
Cefalea Pediatría Urgencias Neuroimágenes |
| topic |
Cefalea Pediatría Urgencias Neuroimágenes CEFALALGIA URGENCIAS PEDIATRICAS Headache Pediatrics Emergency Neuroimaging |
| dc.subject.lemb.spa.fl_str_mv |
CEFALALGIA URGENCIAS PEDIATRICAS |
| dc.subject.keyword.spa.fl_str_mv |
Headache Pediatrics Emergency Neuroimaging |
| description |
La cefalea en los niños es un motivo de consulta frecuente, del cual se conoce el aumento de frecuencia en todas las edades pediátricas. En nuestro medio se desconocen las características clínicas de los pacientes y el uso de medios diagnósticos. Objetivo: Establecer las características clínicas en los niños que consultaron por cefalea al servicio de urgencias en un hospital de tercer nivel de Bogotá, entre Enero de 2013 y Diciembre de 2014. Metodología: Se realizó un estudio observacional descriptivo, tipo corte trasversal, se recolectó información de historias clínicas. Se evaluaron características demográficas, diagnóstico y tratamiento en los pacientes pediátricos que consultaron por cefalea al servicio de urgencias. Resultados: En el periodo estudiado se recibieron 181 interconsultas, se excluyeron 15 casos y se analizaron datos de 166 pacientes. De los pacientes evaluados 91 (54,8%) fueron niñas y 75 niños (45,2%). El promedio de edad fue 9 años, sin encontrase diferencias por género. Con respecto a las características clínicas del dolor, la localización más frecuente fue holocraneano (46,4%), de características opresivas (62,7%) y de forma aguda (79,5%). De los síntomas acompañantes 80 (51,8%) de los pacientes se registró al menos un signo de alarma, vómito en un 30,7%, seguido de fiebre 22,9% Por diagnóstico de egreso las cefaleas primarias fueron el 67% (112), el 85,7% (96) cefalea tensional y migraña 14,2% (16). Del 43% restante 37 pacientes tuvieron diagnóstico de egreso de cefalea secundaria a una enfermedad sistémica y 17 restantes otros diagnósticos. Dos de estos pacientes presentaron diagnósticos de gravedad:meningitis y absceso cerebral. De los 166 pacientes 128 (77%) se les realizó neuroimágenes, 126 Tomografía axial computadorizada de cráneo (TAC) y en dos pacientes resonancia magnética de cerebro (RMC). De los 128 a los que se les tomó neuroimágenes el 52% tenía un signo acompañante y el 48% restante sin indicación de este estudio. Conclusiones: En los resultados encontramos que la cefalea es más frecuente en el grupo de las mujeres, con aumento en la pre adolescencia y adolescencia. Los diagnósticos de egreso fueron similares a los reportados en la literatura mundial siendo el primero cefalea tensional. En el presente estudio encontramos un porcentaje elevado de uso de la TAC para el diagnóstico, y un número elevado de pacientes sin indicación de este estudio. |
| publishDate |
2016 |
| dc.date.accessioned.none.fl_str_mv |
2016-02-02T19:01:30Z 2019-12-30T19:05:04Z |
| dc.date.available.none.fl_str_mv |
2016-02-02T19:01:30Z 2019-12-30T19:05:04Z |
| dc.date.created.none.fl_str_mv |
2016-01-28 |
| dc.type.spa.fl_str_mv |
info:eu-repo/semantics/bachelorThesis |
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http://purl.org/coar/resource_type/c_7a1f |
| dc.type.spa.spa.fl_str_mv |
Trabajo de grado |
| dc.identifier.uri.none.fl_str_mv |
http://hdl.handle.net/10654/7299 |
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http://hdl.handle.net/10654/7299 |
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spa |
| language |
spa |
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http://purl.org/coar/access_right/c_abf2 |
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pdf |
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Medicina |
| dc.publisher.spa.fl_str_mv |
Universidad Militar Nueva Granada |
| dc.publisher.department.spa.fl_str_mv |
Facultad de Medicina |
| dc.publisher.program.spa.fl_str_mv |
Neurología pediátrica |
| institution |
Universidad Militar Nueva Granada |
| dc.source.bibliographicCitation.spa.fl_str_mv |
Hsiao H-J, Huang J-L, Hsia S-H, Lin J-J, Huang I-A, Wu C-T. Headache in the pediatric emergency service: a medical center experience. Pediatr Neonatol. Elsevier Taiwan LLC; 2014 Jun ;55(3):208–12 Conicella E, Raucci U, Vanacore N, Vigevano F, Reale A, Pirozzi N, et al. The child with headache in a pediatric emergency department. Headache. 2008;48(7):1005–11. Lateef TM, Merikangas KR, He J, Kalaydjian A, Khoromi S, Knight E, et al. Headache in a national sample of American children: prevalence and comorbidity. J Child Neurol. 2009;24(5):536–43. Blume HK. Pediatric headache: a review. Pediatr Rev. 2012 Dec;33(12):562–76 Society, Headache Classification Subcommittee of the International HeadacheHeadache HCS of the I. The International Classification of Headache Disorders: 2nd edition. Cephalalgia . 2004;24 Suppl 1:9–160 Lewis DW, Ashwal S, Dahl G, Dorbad D, Hirtz D, Prensky a, et al. Practice parameter: evaluation of children and adolescents with recurrent headaches: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 2002 Aug 27;59(4):490–8 Hershey AD, Hershey AD. Cefaleas. Nelson Textbook of Pediatrics, 19/e. 19th ed. Elsevier; 2013. p. 2114–21 Rasmussen BK, Jensen R, Schroll M, Olesen J. Epidemiology of headache in a general population - A prevalence study. J Clin Epidemiol. 1991;44(11):1147–57 Abu-Arafeh I, Razak S, Sivaraman B, Graham C. Prevalence of headache and migraine in children and adolescents: A systematic review of population-based studies. Dev Med Child Neurol. 2010;52(12):1088–97. 10. Brna PM, Dooley JM. Headaches in the pediatric population. Semin Pediatr Neurol. 2006 Dec 13(4):222–30 Jacobs H, Gladstein J. Pediatric headache: a clinical review. Headache [Internet]. 2012 Feb;52(2):333–9 Scagni P, Pagliero R. Headache in an Italian pediatric emergency department. J Headache Pain. 2008;9(2):83–7 Hershey AD. Current approaches to the diagnosis and management of paediatric migraine. Lancet Neurol. Elsevier Ltd; 2010 Feb [cited 2014 Jul 7];9(2):190–204 Newton RW. Childhood headache. Arch Dis Child Educ Pract Ed .2008 Aug;93(4):105–11 Gelfand A a, Goadsby PJ. Treatment of pediatric migraine in the emergency room. Pediatr Neurol . Elsevier Inc.; 2012 Oct ;47(4):233–41 Dooley JM, Pearlman EM. The clinical spectrum of migraine in children. Pediatr Ann. 2010;39(7):408–15 Stewart WF, Lipton RB, Celentano DD, Reed ML. Prevalence of migraine headache in the United States. Relation to age, income, race, and other sociodemographic factors. JAMA. 1992;267(1):64–9 Sheridan DC, Spiro DM, Meckler GD. Pediatric Migraine: Abortive Management in the Emergency Department. Headache J Head Face Pain. 2014;54(2):235–45 Damen L, Bruijn JKJ, Verhagen AP, Berger MY, Passchier J, Koes BW. Symptomatic treatment of migraine in children: a systematic review of medication trials. Pediatrics 2005 Aug [cited 2014 Jun 23];116(2):e295–302 Sheridan DC, Meckler GD, Spiro DM, Koch TK, Hansen ML. Diagnostic testing and treatment of pediatric headache in the emergency department. J Pediatr [Internet]. Elsevier Ltd; 2013 Dec;163(6):1634–7 Trottier ED, Bailey B, Lucas N, Lortie A. Diagnosis of migraine in the pediatric emergency department. Pediatr Neurol.Elsevier Inc.; 2013;49(1):40–5 Lewis DW. Headaches in Infants and Children 5th ed. Swaiman’s Pediatric Neurology. Elsevier Inc.; 2004. 880-899 Farmer K, Dunn D, Scott E. Psychological factors in childhood headaches. Semin Pediatr Neurol. Elsevier Inc.; 2010 Jun ;17(2):93–9 Brook I. Acute Sinusitis in Children. Pediatr Clin North Am . Elsevier Inc; 2013;60(2):409–24 Kristoffersen ES, Lundqvist C. Medication-overuse headache : a review. J Pain Res. 2014;7:367–78 Hagen K. Management of Medication Overuse Headache: 1-Year Randomized Multicentre Open-Label Trial. Cephalalgia. 2009;29:221–32 Gelfand AA, Goadsby PJ. Medication Overuse in Children and Adolescents. Curr Pain Headache Rep. 2014;1–6 Pinchefsky E, Dubrovsky AS, Friedman D, Shevell M. Part I—Evaluation of Pediatric Post-traumatic Headaches. Pediatr Neurol. Elsevier Inc; 2015;52(3):263–9 Wainwright MS. Disorders of Intracranial Pressure. Swaiman’s Pediatric Neurology. 5th ed. Elsevier Inc.; 2012. p. 1185–97 Wainwright MS. Disorders of Intracranial Pressure. Swaiman’s Pediatric Neurology. 5th ed. Elsevier Inc.; 2012. p. 1185–97 Bernard TJ, Goldenberg N a. Pediatric arterial ischemic stroke. Hematol Oncol Clin North Am [Internet]. Elsevier Ltd; 2010 Feb ;24(1):167–80 Roach ES, Golomb MR, Adams R, Biller J, Daniels S, Deveber G, et al. Management of stroke in infants and children: a scientific statement from a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young. Stroke [Internet]. 2008 Sep;39(9):2644–91 Tsze DS, Valente JH. Pediatric stroke: a review. Emerg Med Int [.2011 Jan;2011:734506 Cha S, Mccracken GH. Bacterial Meningitis in Children. Pediatr Clin North Am. 2005;52:795–810 Mann K, Jackson MA. Meningitis. Pediatr Rev .2008 Dec;29(12):417–29 Fleming AJ, Chi SN. Brain tumors in children. Curr Probl Pediatr Adolesc Health Care. Elsevier Inc.; 2012 Apr ;42(4):80–103 Ullrich NJ, Pomeroy SL. Pediatric brain tumors. Neurol Clin. 2003 Nov;21(4):897–913 Wilne S, Collier J, Kennedy C, Koller K, Grundy R, Walker D. Presentation of childhood CNS tumours: a systematic review and meta-analysis. Lancet Oncol. 2007;8(8):685–95 Sadun A a. Papilledema and Raised Intracranial Pressure. Fourth Edi. Yanoff M, Duker JS, editors. Ophthalmology. Elsevier Ltd; 2014. 875-878 The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 Suppl 4th Report):555–76 Mitsnefes MM. Hypertension in Children and Adolescents. Pediatr Clin North Am. 2006;53:493–512 Falkner B. Hypertension in children and adolescents : epidemiology and natural history. Pediatr Nephrol. 2010;25:1219–24 Ryan MM, Engle EC. Acute Ataxia in Childhood. J Child Neurol. 2003;18(5):309–16 Bonthius DJ. Ataxia and the cerebellum. Semin Pediatr Neurol. Elsevier Inc.; 2011 Jun [cited 2014 Jul 7];18(2):69–71 Nussinovitch M, Prais D, Volovitz B. Post-Infectious Acute Cerebellar Ataxia in Children. 2001;581–4 Volkmar F, Siegel M, Woodbury-Smith M, King B, McCracken J, State M. Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. Elsevier Inc; 2014 Feb;53(2):237–57 Wang S, Fuh J, Lu S. Chronic daily headache in adolescents. Neurology. 2009;73:416–22 Ozge A, Termine C, Antonaci F, Natriashvili S, Guidetti V, Wöber-Bingöl C. Overview of diagnosis and management of paediatric headache. Part I: diagnosis. J Headache Pain. 2011;12(1):13–23 Kan L, Nagelberg J, Maytal J. Headaches in a pediatric emergency department: Etiology, imaging, and treatment. Headache. 2000;40(1):25–9 Bonthius DJ, Karacay B. Meningitis and encephalitis in children. An update. Neurol Clin. 2002 Nov;20(4):1013–38, vi – vii Carvalho KS, Garg BP. Cerebral venous thrombosis and venous malformations in children. Neurol Clin. 2002 Nov;20(4):1061–77 Crawford J. Childhood brain tumors. Pediatr Rev. 2013 Feb;34(2):63–78 Alehan FK. Value of Neuroimaging in the Evaluation of Neurologically Normal Children With Recurrent Headache. J Child Neurol. 2002 Nov 1;17(11):807–9 Alexiou G a, Argyropoulou MI. Neuroimaging in childhood headache: a systematic review. Pediatr Radiol. 2013 Jul;43(7):777–84 |
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Espinosa Garcia, EugeniaCanon Zambrano, Jose Manueljosemanuelcanon@gmail.comEspecialista en Neurología PediátricaMedicina2016-02-02T19:01:30Z2019-12-30T19:05:04Z2016-02-02T19:01:30Z2019-12-30T19:05:04Z2016-01-28http://hdl.handle.net/10654/7299La cefalea en los niños es un motivo de consulta frecuente, del cual se conoce el aumento de frecuencia en todas las edades pediátricas. En nuestro medio se desconocen las características clínicas de los pacientes y el uso de medios diagnósticos. Objetivo: Establecer las características clínicas en los niños que consultaron por cefalea al servicio de urgencias en un hospital de tercer nivel de Bogotá, entre Enero de 2013 y Diciembre de 2014. Metodología: Se realizó un estudio observacional descriptivo, tipo corte trasversal, se recolectó información de historias clínicas. Se evaluaron características demográficas, diagnóstico y tratamiento en los pacientes pediátricos que consultaron por cefalea al servicio de urgencias. Resultados: En el periodo estudiado se recibieron 181 interconsultas, se excluyeron 15 casos y se analizaron datos de 166 pacientes. De los pacientes evaluados 91 (54,8%) fueron niñas y 75 niños (45,2%). El promedio de edad fue 9 años, sin encontrase diferencias por género. Con respecto a las características clínicas del dolor, la localización más frecuente fue holocraneano (46,4%), de características opresivas (62,7%) y de forma aguda (79,5%). De los síntomas acompañantes 80 (51,8%) de los pacientes se registró al menos un signo de alarma, vómito en un 30,7%, seguido de fiebre 22,9% Por diagnóstico de egreso las cefaleas primarias fueron el 67% (112), el 85,7% (96) cefalea tensional y migraña 14,2% (16). Del 43% restante 37 pacientes tuvieron diagnóstico de egreso de cefalea secundaria a una enfermedad sistémica y 17 restantes otros diagnósticos. Dos de estos pacientes presentaron diagnósticos de gravedad:meningitis y absceso cerebral. De los 166 pacientes 128 (77%) se les realizó neuroimágenes, 126 Tomografía axial computadorizada de cráneo (TAC) y en dos pacientes resonancia magnética de cerebro (RMC). De los 128 a los que se les tomó neuroimágenes el 52% tenía un signo acompañante y el 48% restante sin indicación de este estudio. Conclusiones: En los resultados encontramos que la cefalea es más frecuente en el grupo de las mujeres, con aumento en la pre adolescencia y adolescencia. Los diagnósticos de egreso fueron similares a los reportados en la literatura mundial siendo el primero cefalea tensional. En el presente estudio encontramos un porcentaje elevado de uso de la TAC para el diagnóstico, y un número elevado de pacientes sin indicación de este estudio.Headache in children is a frequent complaint, which the frequency increase is known in all pediatric ages. For our clinical setting, the clinical characteristics of patients and the use of diagnostic tools are unknown. Objective: To establish what are the clinical characteristics in children who consulted for headache to the emergency room in a hospital of third level in Bogotá, between January 2013 and December 2014. Objective: To establish what are the clinical characteristics in children who consulted for headache to the emergency room in a hospital of third level in Bogotá, between January 2013 and December 2014. Methodology: A descriptive study, cross-cut type, information was collected medical records was performed. Demographic characteristics, diagnosis and treatment were evaluated in pediatric patients presenting with headache to the emergency room. Results: During the study period 181 interconsultations were received, 15 cases were excluded and data from 166 patients were analyzed. Evaluated 91 patients (54.8%) were girls and 75 boys (45.2%). The average age was nine years, without gender differences. With respect to the clinical characteristics of pain, The most frequent localization was global (46.4%) of oppressive features (62.7%) and acute (79.5%). Regarding accompanying symptoms 80 (51.8%) of patients reported at least one warning sign, vomiting first followed by fever 30.7 22.9% For discharge diagnosis primary headaches was 67% (112), 85.7% (96) tension headache and migraine 14.2% (16). Of the remaining 37 patients they had 43% discharge diagnosis of headache by a systemic disease and 17 remaining other diagnoses. Two of these patients had diagnoses of high risk, meningitis and brain abscess. Of the 166 patients 128 (77%) underwent neuroimaging, 126 cranial computed tomography (CT) and magnetic resonance two brain (RMC) patients. Of the 128 who were made a neuroimaging 52% had an accompanying sign and 48% with no indication of this study remaining. Conclusions: The results found that headache is more common in the group of women with increased pre teens and teens. The discharge diagnoses were similar to those reported in the literature to be the first tension headache. In this study we found a high percentage of use of CT for the diagnosis, and a large number of patients with no indication of this study. pdfspaUniversidad Militar Nueva GranadaFacultad de MedicinaNeurología pediátricaCefaleaPediatríaUrgenciasNeuroimágenesCEFALALGIAURGENCIAS PEDIATRICASHeadachePediatricsEmergencyNeuroimagingCefalea en urgencias pediátricas, clínica y signos de alarmaHeadache in pediatric emergency room, clinic and warning signsinfo:eu-repo/semantics/bachelorThesisTrabajo de gradohttp://purl.org/coar/resource_type/c_7a1fHsiao H-J, Huang J-L, Hsia S-H, Lin J-J, Huang I-A, Wu C-T. Headache in the pediatric emergency service: a medical center experience. Pediatr Neonatol. Elsevier Taiwan LLC; 2014 Jun ;55(3):208–12Conicella E, Raucci U, Vanacore N, Vigevano F, Reale A, Pirozzi N, et al. The child with headache in a pediatric emergency department. Headache. 2008;48(7):1005–11.Lateef TM, Merikangas KR, He J, Kalaydjian A, Khoromi S, Knight E, et al. Headache in a national sample of American children: prevalence and comorbidity. J Child Neurol. 2009;24(5):536–43.Blume HK. Pediatric headache: a review. Pediatr Rev. 2012 Dec;33(12):562–76Society, Headache Classification Subcommittee of the International HeadacheHeadache HCS of the I. The International Classification of Headache Disorders: 2nd edition. Cephalalgia . 2004;24 Suppl 1:9–160Lewis DW, Ashwal S, Dahl G, Dorbad D, Hirtz D, Prensky a, et al. Practice parameter: evaluation of children and adolescents with recurrent headaches: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 2002 Aug 27;59(4):490–8Hershey AD, Hershey AD. Cefaleas. Nelson Textbook of Pediatrics, 19/e. 19th ed. Elsevier; 2013. p. 2114–21Rasmussen BK, Jensen R, Schroll M, Olesen J. Epidemiology of headache in a general population - A prevalence study. J Clin Epidemiol. 1991;44(11):1147–57Abu-Arafeh I, Razak S, Sivaraman B, Graham C. Prevalence of headache and migraine in children and adolescents: A systematic review of population-based studies. Dev Med Child Neurol. 2010;52(12):1088–97. 10. Brna PM, Dooley JM. Headaches in the pediatric population. Semin Pediatr Neurol. 2006 Dec 13(4):222–30Jacobs H, Gladstein J. Pediatric headache: a clinical review. Headache [Internet]. 2012 Feb;52(2):333–9Scagni P, Pagliero R. Headache in an Italian pediatric emergency department. J Headache Pain. 2008;9(2):83–7Hershey AD. Current approaches to the diagnosis and management of paediatric migraine. Lancet Neurol. Elsevier Ltd; 2010 Feb [cited 2014 Jul 7];9(2):190–204Newton RW. Childhood headache. Arch Dis Child Educ Pract Ed .2008 Aug;93(4):105–11Gelfand A a, Goadsby PJ. Treatment of pediatric migraine in the emergency room. Pediatr Neurol . Elsevier Inc.; 2012 Oct ;47(4):233–41Dooley JM, Pearlman EM. The clinical spectrum of migraine in children. Pediatr Ann. 2010;39(7):408–15Stewart WF, Lipton RB, Celentano DD, Reed ML. Prevalence of migraine headache in the United States. Relation to age, income, race, and other sociodemographic factors. JAMA. 1992;267(1):64–9Sheridan DC, Spiro DM, Meckler GD. Pediatric Migraine: Abortive Management in the Emergency Department. Headache J Head Face Pain. 2014;54(2):235–45Damen L, Bruijn JKJ, Verhagen AP, Berger MY, Passchier J, Koes BW. Symptomatic treatment of migraine in children: a systematic review of medication trials. Pediatrics 2005 Aug [cited 2014 Jun 23];116(2):e295–302Sheridan DC, Meckler GD, Spiro DM, Koch TK, Hansen ML. Diagnostic testing and treatment of pediatric headache in the emergency department. J Pediatr [Internet]. Elsevier Ltd; 2013 Dec;163(6):1634–7Trottier ED, Bailey B, Lucas N, Lortie A. Diagnosis of migraine in the pediatric emergency department. Pediatr Neurol.Elsevier Inc.; 2013;49(1):40–5Lewis DW. Headaches in Infants and Children 5th ed. Swaiman’s Pediatric Neurology. Elsevier Inc.; 2004. 880-899Farmer K, Dunn D, Scott E. Psychological factors in childhood headaches. Semin Pediatr Neurol. Elsevier Inc.; 2010 Jun ;17(2):93–9Brook I. Acute Sinusitis in Children. Pediatr Clin North Am . Elsevier Inc; 2013;60(2):409–24Kristoffersen ES, Lundqvist C. Medication-overuse headache : a review. J Pain Res. 2014;7:367–78Hagen K. Management of Medication Overuse Headache: 1-Year Randomized Multicentre Open-Label Trial. Cephalalgia. 2009;29:221–32Gelfand AA, Goadsby PJ. Medication Overuse in Children and Adolescents. Curr Pain Headache Rep. 2014;1–6Pinchefsky E, Dubrovsky AS, Friedman D, Shevell M. Part I—Evaluation of Pediatric Post-traumatic Headaches. Pediatr Neurol. Elsevier Inc; 2015;52(3):263–9Wainwright MS. Disorders of Intracranial Pressure. Swaiman’s Pediatric Neurology. 5th ed. Elsevier Inc.; 2012. p. 1185–97Wainwright MS. 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