Bóle głowy u dzieci – Patofizjologia i mechanizm

Bóle głowy u dzieci
Patofizjologia i mechanizm

Bóle głowy u dzieci, dotykające do 75% populacji szkolnej, dzielą się na pierwotne (migreny, bóle napięciowe, trójdzielno-autonomiczne) oraz wtórne, będące objawem innych schorzeń. Migrena, najczęstszy pierwotny ból głowy, ma złożoną patogenezę obejmującą predyspozycje genetyczne (ryzyko dziedziczenia 50-90%), aktywację układu trójdzielno-naczyniowego z udziałem peptydu CGRP, korowe rozchodzenie się depolaryzacji (CSD) oraz zmiany neurochemiczne (obniżone poziomy glutaminianu w korze wzrokowej u dzieci z aurą). Czynniki hormonalne, takie jak wczesne pojawienie się miesiączki (około 12 lat), oraz psychobiologiczne aspekty, w tym stres i zaburzenia snu, odgrywają istotną rolę w etiologii migreny i innych bólów głowy. Bóle napięciowe, najczęstsze u dzieci, wynikają z napięcia mięśniowego i centralnej sensytyzacji, często nasilanej przez stres psychospołeczny. Klasterowe bóle głowy wiążą się z aktywacją układu trójdzielno-autonomicznego i podwzgórza, manifestując się objawami autonomicznymi po stronie bólu.

Patogeneza bólów głowy u dzieci

Bóle głowy u dzieci to powszechny problem, dotykający nawet 75% dzieci w wieku szkolnym, przy czym częstość występowania wzrasta wraz z wiekiem. Jest to objaw, a nie odrębna choroba, który może mieć liczne przyczyny – od łagodnych i niegroźnych po rzadkie, ale poważne schorzenia¹². Zrozumienie patogenezy bólów głowy u dzieci wymaga rozważenia złożonych mechanizmów, które różnią się w zależności od typu bólu głowy.

Klasyfikacja bólów głowy

Bóle głowy u dzieci można podzielić na dwie główne kategorie:¹²

Bóle głowy pierwotne – nie są powiązane z innym schorzeniem. Wynikają najczęściej z napięcia mięśni, rozszerzenia naczyń krwionośnych, zmian w przekaźnictwie nerwowym lub stanu zapalnego w niektórych częściach mózgu. Do tej kategorii należą migreny, bóle napięciowe oraz trójdzielno-autonomiczne bóle głowy.
Bóle głowy wtórne – są objawem innego schorzenia lub choroby. Mogą być spowodowane infekcją, urazem głowy, guzem mózgu lub innymi zaburzeniami.

¹²

Migrena u dzieci – mechanizmy

Migrena jest najczęstszym pierwotnym bólem głowy u dzieci i stanowi poważny problem medyczny¹. Dawniej uważano, że migrena jest chorobą naczyniową, jednak obecnie uznaje się ją za chorobę mózgu¹². Mechanizm rozwoju migreny jest złożony i obejmuje wiele etapów:

1. Predyspozycje genetyczne – migrena jest uznawana za silnie dziedziczną chorobę. Jeśli jeden z rodziców cierpi na migrenę, dziecko ma 50% szans na jej dziedziczenie, a przy obojgu rodziców ryzyko wzrasta do 90%¹²³.

2. Fazy ataku migreny – typowy atak migreny składa się z czterech faz: prodromalnej (zwiastującej), aury, fazy bólu głowy i fazy postdromalnej¹.

3. Aktywacja układu trójdzielno-naczyniowego – podczas migreny dochodzi do aktywacji układu trójdzielno-naczyniowego, w którym neurony nocyceptywne unerwiające oponę twardą uwalniają różne peptydy wazoaktywne, w tym najbardziej aktywny peptyd związany z genem kalcytoniny (CGRP)¹².

4. Korowe rozchodzenie się depolaryzacji (CSD) – aura migrenowa, występująca u około jednej trzeciej wszystkich pacjentów z migreną, jest związana z odwracalnym zjawiskiem neurobiologicznym, które polega na rozprzestrzenianiu się depolaryzacji przez korę mózgową¹.

5. Zmiany neurochemiczne – badania pokazują, że w patofizjologii migreny istotną rolę odgrywają zmiany w neuroprzekaźnikach, takich jak serotonina, dopamina i glutaminian¹. U dzieci z migreną i aurą zaobserwowano znacząco niższe poziomy glutaminianu w korze wzrokowej¹.

6. Stan zapalny – zmiany neurochemiczne prowadzą do aktywacji układu trójdzielno-naczyniowego i ostatecznie do neurogennego stanu zapalnego¹.

7. Czynniki hormonalne – hormony również odgrywają rolę w patogenezie migreny. Wczesne pojawienie się miesiączki (12 lat) jest związane ze zwiększonym ryzykiem migreny i innych bólów głowy u nastolatek¹.

Bóle napięciowe dziecięce

Bóle napięciowe (TTH – Tension-Type Headache) są najczęstszym typem bólu głowy u dzieci, choć zazwyczaj są mniej dotkliwe niż migreny¹. Mechanizm powstawania obejmuje:

Napięcie mięśni głowy i szyi, często w odpowiedzi na stres fizyczny lub emocjonalny¹.
Ból pochodzący ze struktur miofascjalnych, który jest wzmagany przez mechanizmy centralnej sensytyzacji¹.
U nastolatków bóle napięciowe mogą być wywoływane przez stres związany z rodziną, szkołą lub rówieśnikami¹.

Trójdzielno-autonomiczne bóle głowy

W rozwoju klasterowych bólów głowy uczestniczą interakcje między szlakiem trójdzielno-naczyniowym, odruchem trójdzielno-autonomicznym, podwzgórzem oraz neuropeptydami CGRP i aktywującym przysadkową cyklazę adenylową polipeptydem¹. Te bóle głowy charakteryzują się autonomicznymi zmianami, takimi jak zaczerwienienie oczu i łzawienie po tej samej stronie, na której występuje ból, zatkany i cieknący nos, pocenie się, blada skóra i możliwe opadanie powieki¹².

Czynniki ryzyka i wyzwalające

Wiele czynników może zwiększać ryzyko lub wyzwalać bóle głowy u dzieci:¹²³

Stres i czynniki emocjonalne – niepokój i stres, być może wywołane problemami z rówieśnikami, nauczycielami lub rodzicami.
Zaburzenia snu – zarówno zbyt mała, jak i zbyt duża ilość snu może przyczyniać się do wystąpienia bólów głowy. Zaburzenia snu są najczęstszym schorzeniem współistniejącym z migreną w dzieciństwie.
Dieta i nawodnienie – pomijanie posiłków, odwodnienie oraz niektóre pokarmy mogą wyzwalać bóle głowy.
Czynniki środowiskowe – zmiany pogody, głośne hałasy, zapachy i jasne światła.
Predyspozycje genetyczne – bóle głowy, szczególnie migreny, mają tendencję do występowania rodzinnie.
Otyłość – ryzyko migreny wzrasta wraz ze wzrostem otyłości u dzieci.

¹²

Oś jelito-mózg i ból głowy

Coraz więcej badań wskazuje na rolę osi jelito-mózg w patogenezie bólów głowy u dzieci¹. Komunikacja między układem jelitowym a ośrodkowym układem nerwowym (OUN) może wyjaśnić, w jaki sposób zmiany jelitowe są związane z migreną. Przykładem jest patofizjologia kolki niemowlęcej, na którą wpływa również niedojrzały OUN¹. Istnieją dowody sugerujące, że kolka niemowlęca może być wczesnym wyrazem migreny, co pokazuje powiązanie między koliką niemowlęcą a późniejszą migreną u dziecka oraz migreną matki¹.

Warianty migreny w dzieciństwie

U dzieci mogą występować różne warianty migreny, które rzadko pojawiają się u dorosłych:¹

Łagodne napadowe zawroty głowy u dzieci
Migrena brzuszna
Cykliczne wymioty w dzieciństwie
Ostra migrena dezorientacyjna (ostry stan dezorientacji)
Napadowe kręcz szyi
Kolka niemowlęca (związek epidemiologiczny z migreną)

Patogeneza migreny brzusznej może być związana ze zwiększoną aktywnością ośrodkowego układu nerwowego w odpowiedzi na bodźce wyzwalające, co prowadzi do uwolnienia neuropeptydów i neuroprzekaźników powodujących dysregulację układu pokarmowego¹.

Rola zaburzeń mitochondrialnych

Istnieją coraz liczniejsze dowody na to, że kilka polimorfizmów mitochondrialnego DNA jest związanych zarówno z zespołem cyklicznych wymiotów, jak i migreną bez aury¹. Nieprawidłowości mitochondrialne (dziedziczone matczyście przez mitochondrialny DNA, recesywnie przez chromosomalny DNA lub sporadyczne) mogą odpowiadać za niektóre przypadki migreny brzusznej lub cyklicznych wymiotów u dzieci¹.

Bóle głowy szyjnopochodne

Patogeneza i etiologia bólów głowy szyjnopochodnych (CEH) pozostaje wyzwaniem, ponieważ różne struktury mogą być przyczynowe, a nie pojedyncza jednostka¹. Mechanizm obejmuje:

Zbieżność włókien nerwu trójdzielnego i trzech górnych nerwów rdzeniowych szyjnych na neuronach drugiego rzędu w jądrze trójdzielno-szyjnym w górnym rdzeniu kręgowym, co prawdopodobnie prowadzi do bólu głowy¹.
Produkcję cytokin prozapalnych, które przyczyniają się do sensytyzacji neuronalnej, prowadzącej do przewlekłych zespołów bólowych¹.
Szkodliwe bodźce z kręgosłupa szyjnego mogą aktywować układ trójdzielno-naczyniowy, powodując kaskadę neurozapalną potęgującą proces zachodzący w innym bólu głowy¹.

Psychobiologiczne aspekty bólów głowy

Bóle głowy u dzieci mają istotny komponent psychobiologiczny¹. Szczególnie u młodszych dzieci, niewygodna sytuacja, problem psychologiczny lub stres emocjonalny rzadko są wyrażane bezpośrednio, ale zwykle poprzez objawy fizyczne. Migrena może być zatem uznana za zaburzenie adaptacji psychobiologicznej, w którym predyspozycje genetyczne współdziałają z wewnętrznymi i/lub zewnętrznymi wpływami środowiskowymi, takimi jak czynniki psycho-emocjonalne, klimatyczne, hormonalne, dietetyczne lub inne¹.

Badania wykazały zmniejszoną łączność w sieci trybu domyślnego (DMN) u dzieci z migreną, co może stanowić wczesny biomarker migreny, prawdopodobnie związany z nieprzystosowawczą odpowiedzią mózgu¹. Te zmiany mogą być związane z trudnościami w regulacji emocji i wyrażaniu uczuć¹.

Stres i odpowiedź adaptacyjna

Rola nieprzystosowawczej odpowiedzi na stres w migrenie stała się przedmiotem dużego zainteresowania w ostatnich latach¹. Stres może powodować modyfikacje biologiczne obniżające próg indywidualnej podatności na atak migreny¹. Dobrze znana nadwrażliwość na ból, powszechna u większości pacjentów z migreną, wydaje się być bardziej związana z tym, jak te bodźce są indywidualnie przetwarzane, niż z ich istotą¹.

Relacja matka-dziecko wpływa na szczególny składnik temperamentalny dziecka i odwrotnie, odgrywając rolę w występowaniu ataków migreny¹.

Migrena jako czynnik ryzyka chorób sercowo-naczyniowych

Ostatnie dane sugerują, że niektóre czynniki ryzyka miażdżycy i agregacji płytek (tj. czynnik neurotroficzny pochodzenia mózgowego (BDNF), rozpuszczalny ligand CD40 (sCD40L), serpina E1/PAI I (śródbłonkowy inhibitor aktywatora plazminogenu) i czynnik wzrostu śródbłonka naczyniowego (VEGF)) mogą być zaangażowane w podstawowe procesy idiopatycznych bólów głowy¹.

Wiedza na temat korelacji między bólami głowy a czynnikami, które mogą zwiększać ryzyko miażdżycy, a w konsekwencji przedwczesnej choroby wieńcowej, może mieć szczególne znaczenie, zwłaszcza w populacji pediatrycznej¹. Migrena była sugerowana jako jeden z pierwszych objawów zaburzeń metabolizmu lipidów, a podwyższone stężenia lipidów były powszechnie obserwowane u dorosłych cierpiących na migrenę, jak również w kilku badaniach klinicznych przeprowadzonych u pacjentów pediatrycznych¹.

Konsekwencje przewlekłych bólów głowy

Dzieci z nawracającymi bólami głowy mają około dwukrotnie większe prawdopodobieństwo nawracających bólów głowy w dorosłości, a także zwiększone prawdopodobieństwo wystąpienia innych objawów fizycznych i współistniejących chorób psychicznych¹. Przewlekłe bóle głowy, szczególnie migreny, mogą prowadzić do znacznej niepełnosprawności i wpływać na całą rodzinę¹.

Zaburzenia bólów głowy są główną przyczyną nieobecności w szkole, negatywnie wpływając na wyniki w nauce, a także inne codzienne aktywności¹. Wczesna interwencja uwzględniająca czynniki chemiczne, mechaniczne i psychologiczne przyczyniające się do bólu głowy u danej osoby jest niezbędna. Zmniejsza to ryzyko centralnej sensytyzacji związanej z przewlekłością i niepełnosprawnością, w tym ryzyko bólu głowy w wieku dorosłym¹.

Bóle głowy pourazowe

Ból głowy jest najczęstszym objawem doświadczanym po urazie głowy zarówno w okresie ostrym, jak i przewlekłym¹. Międzynarodowa Klasyfikacja Bólów Głowy (ICHD-3) definiuje pourazowe bóle głowy (PTHA) jako ból głowy rozpoczynający się w ciągu 7 dni od urazu lub powrotu świadomości po urazowym urazie głowy¹.

Szeroka różnorodność prezentacji PTHA sugeruje, że może istnieć wiele mechanizmów leżących u podstaw bólu głowy po urazie głowy. Ostry ból głowy jest prawdopodobnie bezpośrednim wynikiem związanego z nim urazu głowy. Jednak mechanizm leżący u podstaw przewlekłych objawów pourazowego bólu głowy jest bardziej niejednoznaczny i przypuszcza się, że obejmuje znaczne przesunięcia biochemiczne¹.

Diagnostyka i leczenie

Rozpoznanie bólów głowy u dzieci, zwłaszcza migreny, pozostaje diagnozą kliniczną¹. W diagnostyce migreny u pacjentów pediatrycznych szczególne znaczenie przywiązuje się do dokładnego wywiadu klinicznego¹.

Leczenie bólów głowy zależy od wieku dziecka, typu i częstotliwości bólów głowy oraz innych czynników¹. Wytyczne zalecają stosowanie ibuprofenu w dawce 7,5-10 mg/kg jako leczenia pierwszego rzutu dla wszystkich dzieci i młodzieży¹. Jeśli ibuprofen jest niewystarczający, można rozważyć tryptan¹.

Leczenie profilaktyczne należy rozważyć u wszystkich dzieci, które mają częste bóle głowy lub znaczną niepełnosprawność związaną z bólem głowy, lub jedno i drugie¹. U dzieci z niepokojami, depresją lub znacznym stresem, korzystanie z pomocy dostawcy zdrowia psychicznego jest bardzo pomocne¹.

Podsumowanie wiedzy o patogenezie

Patogeneza bólów głowy u dzieci jest złożona i wieloczynnikowa, angażująca procesy genetyczne, biochemiczne, naczyniowe, neurologiczne i psychologiczne. Głębsze zrozumienie mechanizmów leżących u podstaw różnych typów bólów głowy u dzieci jest kluczowe dla opracowania skuteczniejszych strategii diagnostycznych i terapeutycznych.

Współczesne podejście do bólów głowy u dzieci uwzględnia model biopsychospołeczny, biorąc pod uwagę nie tylko czynniki biologiczne, ale również psychologiczne i środowiskowe¹. Wczesna i właściwa interwencja może znacząco zmniejszyć długoterminowy wpływ bólów głowy na jakość życia dziecka i ryzyko przewlekłych bólów głowy w dorosłości¹.

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Materiały źródłowe

#1 Patient education: Headache in children (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/headache-in-children-beyond-the-basics/print
Headaches are a common complaint in children and adolescents, occurring in up to 75 percent of school-aged children. The frequency of headaches is greater in adolescents than in younger children. There are many possible causes of headaches, from common and nonharmful to rare but serious conditions. […] Headache is a symptom and not a disease or disorder itself. Thus, there can be numerous possible causes of headaches in children. The most common causes include the following: Migraine, Tension-type headache, As a symptom associated with viral or upper respiratory infections (including ear infections, the common cold, allergies, sinus infections, strep throat), As a consequence of a minor or moderate head injury. Only a small minority of children with headaches have a serious underlying cause, such as a brain tumor or life-threatening infection.
#1 Headaches in Children | Cedars-Sinai
https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/h/headaches-in-children.html
A headache is pain or discomfort in one or more areas of the head or face. Headaches are often divided into two groups, based on what causes them: Primary headaches. These are not linked to another health condition. They are often caused by tight muscles or changes in blood vessels or nerve signals. Secondary headaches. These are a less common type of headache. They are caused by a problem in the brain, or another health condition or disease. Researchers dont fully understand the exact cause of headaches. Many headaches may be caused by tight muscles and widened (dilated) blood vessels in the head. Stress and mental or emotional conflict can set off tension headaches. Migraine headaches may be caused by changes in brain chemicals or nerve signals. Other headaches may be caused by a change in pain signals from nerves in the head, face, and neck. Lack of sleep and poor sleep quality are often the cause of chronic headaches. In rarer cases, headaches may be caused by a problem in the brain, such as a tumor.
#1 Headaches in Children – Stanford Medicine Children’s Health
https://www.stanfordchildrens.org/en/topic/default?id=headaches-in-children-90-P02603
A headache is pain or discomfort in one or more areas of the head or face. […] Headaches are often divided into 2 groups, based on what causes them: […] Primary headaches are not linked to another health condition. They are usually caused by tight muscles, widened (dilated) blood vessels, changes in nerve signals, or swelling (inflammation) in parts of the brain. […] Researchers don’t fully understand the exact cause of headaches. Many headaches may be caused by tight muscles and widened (dilated) blood vessels in the head. Stress and mental or emotional conflict can trigger tension headaches. Migraine headaches may be caused by changes in brain chemicals or nerve signals. […] Other headaches may be caused by a change in pain signals from nerves in the head, face, and neck. Lack of sleep and poor sleep quality are often the cause of chronic headaches. In rarer cases, headaches may be caused by a problem in the brain such as a tumor.
#1 Migraine Headache in Childhood – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557813/
Migraine is the most frequent primary headache disorder in children and adolescents. […] The diagnosis of migraine in children and adolescents remains a clinical diagnosis. […] Migraine is considered a strongly heritable disorder. […] Migraine is now considered a brain disease. In the past, it was thought of as a vascular disease. This new theory requires the brain to be genetically sensitive to migraine-inducing neurochemical changes that result in premonitory symptoms. Migraine consists of trigeminal vascular system activation wherein nociceptive neurons that innervate the dura release various vasoactive peptides, including the most active calcitonin gene-related peptide. […] These neurochemical changes lead to trigeminovascular activation and, eventually, neurogenic inflammation.
#1 Annals of Child Neurology
https://www.annchildneurol.org/m/journal/view.php?number=1372
Pediatric headache is a common condition that often results in frequent outpatient visits. […] The management of migraine focuses on lifestyle modifications, behavioral therapy, and pharmacotherapy for acute episodes and long-term preventive therapy. […] The pathophysiology of headaches is intricate, with genetic and environmental factors playing crucial roles in the development of migraine, tension-type headache, and cluster headache. […] The vascular theory of migraines, according to which migraine stems from blood vessel dilation and that the aura is a result of vasoconstriction, is now deemed invalid, as evidenced by magnetic resonance angiography studies. […] A typical migraine episode consists of four phases: the prodromal or premonitory phase, the aura phase, the headache phase, and the post-dromal phase.
#1 Annals of Child Neurology
https://www.annchildneurol.org/m/journal/view.php?number=1372
The migraine aura constitutes a reversible neurological phenomenon impacting approximately one-third of all migraine sufferers and occasionally overlapping with the headache phase. […] The underlying mechanism of this phase is thought to involve cortical spreading depolarization (CSD) across the cortex. […] The headache phase is characterized by the activation of the trigeminocervical complex. […] Neuropeptides, particularly calcitonin gene-related peptide (CGRP), are involved in trigeminal activation and have emerged as a potential target for therapeutic interventions in migraine patients. […] The development of cluster headaches involves interactions among the trigemino-vascular pathway, trigeminal autonomic reflex, hypothalamus, and the neuropeptides CGRP and pituitary adenylate cyclase-activating polypeptide. […] In tension-type headaches, the pain is thought to stem from myofascial structures and is heightened by central sensitization mechanisms.
#1 What causes migraine headaches in children? | Norton Children’s Louisville, Ky.
https://nortonchildrens.com/news/causes-migraine-headaches-in-children/
A migraine attack can be triggered by many things. These triggers can lead to a change in neurological activity in the brain that causes the onset of a migraine attack. This abnormal brain activity may trigger chemicals that can cause temporary changes to blood flow and inflammation in the brain, which can cause the painful symptoms often associated with migraine. […] Research shows that changes in neurotransmitters, like serotonin, dopamine and glutamate are involved in the changes in brain activity related to migraine.
#1 Migraine Headache in Childhood – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557813/
The possible reason why children have more severe and cyclic vomiting compared to adults is related to their reduced cholinergic function. […] Copeptin levels were significantly higher in patients with childhood migraine. […] In line with an imbalance in cortical excitability, GABA-edited Magnetic resonance spectroscopy (MRS) studies revealed that children (7 to 13 years) with migraine and aura had significantly lower glutamate levels in the visual cortex. […] The most common comorbidity with migraine in childhood is sleep disorders. […] The function of the insula, the hypothalamic-pituitary-adrenal axis, the serotonergic system, and the unstable hyperactivated neural networks may trigger the pathophysiology of both migraine and its psychiatric comorbidities. […] An evaluation of hypertension in children with migraine by performing ambulatory blood pressure monitoring (ABPM) showed that although the frequency of hypertension was not higher, abnormal ABPM patterns were significantly more frequent in the migraine group. […] Some studies evaluated the clinical interdependency of myofascial trigger points and migraine in children, which would support an interaction of spinal and trigeminal afferents in the trigeminal-cervical complex as a contributing factor in migraine.
#1 Headache in Children and Adolescents
https://pmc.ncbi.nlm.nih.gov/articles/PMC9455826/
Headaches are a very common and disabling problem for children and adolescents. Globally, nearly 60% of children and adolescents experience significant headache, and 7.7% to 9.1% have migraine. […] This disability is complicated by the fact that migraine is a silent disease; no outward findings are visible, so the child’s report of pain may be doubted, leading to shame and frustration. […] Migraine is the leading cause of disability worldwide for older adolescents and young adults. […] Migraine is a primary headache disorder characterized by recurrent (at least five) episodes of moderate to severe pulsating head pain lasting hours and accompanied by nausea/vomiting and sensitivity to light and sound. […] Genetic and epigenetic factors likely play a role in the age of onset. […] Hormones also play a role. Early menarche (12 years of age) is associated with increased odds of migraine and other headaches in adolescent girls.
#1 Headaches – Kids Plus Pediatrics
https://www.kidsplus.com/parent-resources/doctors-notes/headaches/
Headaches are common in childhood. 58% of children reported some form of headache over the past year. Based on research, a practical headache classification includes primary and secondary headaches. […] Primary headaches are headaches that are NOT the result of another medical condition. They include: acute recurrent headaches (or, migraines) and chronic non-progressive headaches (or, tension-type headaches). Secondary headaches result from another medical condition. Acute headaches most commonly result in a visit to the pediatricians office. If there are no neurological signs or symptoms, the most common cause for acute headaches in children and teens is a cold or sinus infection. […] Children can also get migraine or tension headaches. Tension headaches are the most common type of headache in children, but are generally less severe than migraine headaches. Stress and mental or emotional conflict often trigger pain related to tension headaches.
#1 When Your Child Has Tension Headaches | Saint Luke’s Health System
https://www.saintlukeskc.org/health-library/when-your-child-has-tension-headaches
It’s not uncommon for children to get a type of headache called tension headaches. These headaches can be painful. But they are rarely a sign of a major health problem. Treatment can help your child feel better. Also, certain things can be done to help prevent tension headaches. […] Tension headaches can have many causes. Common causes in children are: Tension (physical or emotional), Hunger, Trouble with eyesight, Eyestrain due to reading, video games, or computer use, Exposure to very strong smells (such as perfume or tobacco), Tiredness, Sinus infection or allergies, Overheating, Fluid loss (dehydration). […] To prevent headaches, avoid your childs specific triggers. Triggers are things or events that cause headaches to occur. Some common triggers are hunger, eyestrain, strong odors, and tiredness. You and your child should learn their triggers and avoid them when possible. Be sure your child is eating well, getting enough sleep, getting daily physical activity, and limiting computer and TV time.
#1 Childrens Headache Disorders | National Headache Foundation
https://headaches.org/resources/childrens-headache-disorders/
Tension headache is the most common cause of recurrent headache in children. […] Tension-type headaches are triggered by emotional stress related to family, school or schoolmates, or friends. […] Tension-type headaches do not have the hereditary factor that migraines do, and they are not caused by organic problems or serious diseases. […] Once a child’s pediatrician or pediatric neurologist has diagnosed the headache, and ruled out organic causes, you should help your child pursue a rewarding lifestyle.
#1 Patient education: Headache in children (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/headache-in-children-beyond-the-basics/print
The headache is usually deep, excruciating, continuous, and explosive in quality. Cluster headaches commonly include autonomic changes, such as eye redness and tear production on the same side on which the pain occurs, a stuffy and runny nose, sweating, a pale appearance, and possibly drooping of the eyelid. […] The treatment of headaches depends upon the child’s age, the type and frequency of headaches, and other factors. […] Chronic headaches occur â¥15 days per month. The treatment of chronic migraine or chronic tension-type headaches is usually multimodal and includes preventive treatment, healthy lifestyle adjustment, and CBT.
#1 Headaches in Children – Stanford Medicine Children’s Health
https://deprod.stanfordchildrens.org/en/topic/default?id=headaches-in-children-90-P02603
Other headaches may be caused by a change in pain signals from nerves in the head, face, and neck. Lack of sleep and poor sleep quality are often the cause of chronic headaches. In rarer cases, headaches may be caused by a problem in the brain such as a tumor. […] A child is more at risk for headaches if he or she has any of the following: Stress, Poor sleep, Head injury, Family history of migraines. […] Headaches of any type that come back again and again (recurrent) can cause: Behavior problems, Problems with grades at school, Depression.
#1 Headache in Children: Selected Factors of Vascular Changes Involved in Underlying Processes of Idiopathic Headaches
https://www.mdpi.com/2227-9067/7/10/167
Headaches are common complaints in children. The International Classification of Headache Disorders, 3rd edition (beta version), defines more than 280 types of headaches. Primary headaches refer to independent conditions that cause pain and include migraine, tension-type headaches (TTH), and trigeminal autonomic cephalalgias (TACs). Several agents are involved in the pathogenesis of headaches. The factors associated with predisposition to atherosclerosis seem to be particularly important from the clinical point of view. The influence of obesity on the incidence of headaches has been well established. Moreover, idiopathic headaches, especially migraine, are thought to be one of the first signs of disorders in lipid metabolism and atherosclerosis. The risk of migraine increases with increasing obesity in children.
#1 Brain to Belly: Abdominal Variants of Migraine and Functional Abdominal Pain Disorders Associated With Migraine
https://www.jnmjournal.org/journal/view.html?uid=1703&vmd=Full&
Migraine is one of the most frequent causes of primary headache and 9% of children suffer from migraines. […] The common pathophysiological root of these diseases seems to be the gut-brain axis mechanism. […] The pathophysiology of migraine is a multifactorial phenomenon, dependent on genetic factors, environmental factors, and metabolic factors. […] The activation of the hypothalamus results in an alteration in thalamo-cortical circuits and brain connectivity, which subsequently leads to calcitonin gene-related peptide (CGRP) and pituitary adenylate cyclase-activating polypeptide (PACAP) release. […] The communication between the enteric and the central nervous system (CNS), best known as the gut-brain axis, helps us to understand how these intestinal changes are related to migraine.
#1 Brain to Belly: Abdominal Variants of Migraine and Functional Abdominal Pain Disorders Associated With Migraine
https://www.jnmjournal.org/journal/view.html?uid=1703&vmd=Full&
The pathophysiology of infantile colic is also a good model of the gut-brain axis mechanism. […] The complexity of infantile colic is also influenced by an immature CNS. […] The first case report linking migraine to infantile colic was published by Katerji and Painter in 1994 and describes an infantile migraine presenting as colic. […] The hypothesis has been strengthened by studies linking parental migraine to infantile colic, allowing us to consider the possibility that these phenomena are symptoms on the same spectrum. […] Migraine and related syndromes have a great impact on the quality of life of children and their future as adults. […] The understanding of pathophysiological mechanisms underlying these conditions is crucial in order to improve diagnosis, treatment, and follow-up in these children.
#1 Childhood Migraine Variants: Background, Pathophysiology and Etiology, Epidemiology
https://emedicine.medscape.com/article/1178141-overview
Presentations of migraine in children may be similar to adult presentations and may include headache, with or without aura, accompanied by nausea, vomiting, photophobia, and relief with sleep. However, several variations of migraine are unique to children and rarely if ever occur in adults. […] Recognized childhood syndromes assumed to be pathophysiologically related to migraine include the following: Benign paroxysmal vertigo of childhood, Abdominal migraine, Cyclic vomiting of childhood, Acute confusional migraine (acute confusional state), Paroxysmal torticollis, Infant colic (epidemiologic association with migraine). […] Evidence suggests that infant colic may be an early-life expression of migraine. Epidemiologic associations are found between both infant colic and later migraine in the child, and maternal migraine.
#1 Migraine in childhood: biobehavioural or psychosomatic disorder? | The Journal of Headache and Pain | Full Text
https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-016-0675-0
This change may in fact represent a high stress load and increased requirements on adaptive abilities in a child’s life which may results in homoeostatic unbalances and in headache. […] The pathogenesis of abdominal migraine could be linked to an increased arousal in the central nervous system (CNS) in response to triggers, thus releasing neuropeptides and neurotransmitters that lead to dysregulation of the gastrointestinal system. […] Several periodic syndromes of childhood, including abdominal migraine were described like common precursors of migraine. […] The mother-child relationship interferes on peculiar temperamental component of the child and vice-versa, and it plays a role in the occurrence of migraine attacks. […] The wide influence of environmental factors on migraine has led to consider migraine as a bio-psychosocial condition, caused by cognitive, emotional and environmental factors, as well as biological.
#1 Childhood Migraine Variants: Background, Pathophysiology and Etiology, Epidemiology
https://emedicine.medscape.com/article/1178141-overview
Although migraine and variants of migraine have long been assumed to have a vascular etiology, increasing evidence points to underlying primary neurologic causes. […] Some forms of migraine are genetic. Specific markers on chromosome 19 were found in some families with hemiplegic migraine. […] Mitochondrial abnormalities (maternally inherited via mitochondrial DNA, recessively inherited via chromosomal DNA, sporadic) may account for some cases of abdominal migraine or cyclic vomiting of childhood. […] There is increasing evidence that several mitochondrial DNA polymorphisms are associated both with cyclic vomiting syndrome and migraine without aura. […] As information from genetic diagnosis and whole exome sequencing rapidly expands, a number of channelopathy-related genetic syndromes have been found to include variable combinations of epilepsy syndrome, familial hemiplegic migraine, paroxysmal vertigo of childhood, episodic ataxia, and paroxysmal dyskinesias.
#1
https://chiro.org/Graphics_Box_PEDS/ABSTRACTS/Headaches_in_Children_Part_2.shtml
The pathogenesis and etiology of CEH remain a challenge as different structures can be causative as opposed to a single entity. […] Cervicogenic headaches commonly become chronic. This is thought to be the result of the production of proinflammatory cytokines which contribute to neuronal sensitization resulting in chronic pain syndromes. […] The neuromusculoskeletal result of spinal dysfunction can initiate or perpetuate a primary headache. Noxious input from the cervical spine can activate the trigeminovascular system resulting in a neuroinflammatory cascade potentiating the process occurring in another headache. […] Proper treatment early on can reduce and interrupt the disability and chronicity associated with pain sensitization.
#1
https://chiro.org/Graphics_Box_PEDS/ABSTRACTS/Headaches_in_Children_Part_2.shtml
The major headache categories involve chemical, psychological and mechanical factors which activate the trigeminal nociceptive system resulting in a neuroinflammatory cascade causing and exacerbating headaches. […] A primary headache is caused by dysfunction or overactivity of pain-sensitive structures in the head, and is not a symptom of an underlying disease. […] Migraine headaches, tension-type headaches and new persistent daily headaches are common examples of primary headaches in children. […] Another primary headache form has more of a psychological profile and a common secondary headache form is due to biomechanical dysfunction involving the cervical spine. […] The pathogenesis of CEH may originate from various anatomic structures in the cervical spine. Convergence of afferents of the trigeminal and upper three cervical spinal nerves onto the second-order neurons in the trigemino-cervical nucleus in the upper cervical spinal cord is likely to lead to the headache.
#1 Migraine in childhood: biobehavioural or psychosomatic disorder? | The Journal of Headache and Pain | Full Text
https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-016-0675-0
It is well documented that headache is a multifactorial disorder which includes not only genetic, biological, medical and neuropsychological factor but also psychological and personality traits. […] In particular in younger children, an uncomfortable situation, a psychological problem or an emotional distress is rarely expressed directly but usually through physical symptoms. So migraine may be considered as a disorder of psychobiological adaptation in which genetic predisposition interplays with internal and/or external environmental influences such as psycho-emotional, climatic, hormonal, dietary or other factors. […] When a child with migraine is referred to a doctor, the doctor may be often surprised by the large amount of accompanying symptoms and comorbidities at the time point of investigation or in the past clinical history: soft neurological signs, sleep disturbances, allergy, problems with school achievement, lack of concentration, school phobia, hyperactivity, periodic syndromes, anxiety and depression, as well as panic attacks.
#1 Migraine in childhood: biobehavioural or psychosomatic disorder? | The Journal of Headache and Pain | Full Text
https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-016-0675-0
Indeed the role of a maladaptive stress response in migraine has become of great interest in recent years. […] The authors believe that these reduced connectivity in DMN may represent an early migraine biomarker, probably associated to a maladaptive brain response. […] Specific changes in connectivity of DMN could be associated to the difficulty to regulate emotions and to express feelings. […] Therefore individuals with alexithymia are more likely to have headache and other somatic complaints because they would lack the necessary skills to modulate the emotions and the adequate coping reaction to a stressful situation. […] Stress can provoke biological modifications lowering the threshold of the individuals susceptibility to a migraine attack. […] Indeed, it seems likely that the well-known hypersensitivity to pain common in the majority of migraine patients, is related more to how these stimuli are individually processed than to their intrinsic nature.
#1 Headache in Children: Selected Factors of Vascular Changes Involved in Underlying Processes of Idiopathic Headaches
https://www.mdpi.com/2227-9067/7/10/167
Recent data suggest that some risk factors for atherosclerosis and platelet aggregation (i.e., brain-derived neurotrophic factor (BDNF), sCD40L (soluble CD40 ligand), serpin E1/PAI I (endothelial plasminogen activator inhibitor), and vascular endothelial growth factor (VEGF)) may be involved in the underlying processes of idiopathic headaches. […] The knowledge on the correlation between headaches and factors, which may increase the risk of atherosclerosis, and consequently, premature coronary artery disease, may be of particular importance, especially in the pediatric population. […] A number of risk factors for headache have been demonstrated. Predisposition to atherosclerosis in idiopathic headaches seems to be particularly important from the clinical point of view. Migraine was suggested to be one of the first signs of disorders in lipid metabolism. Elevated lipid concentrations were widely observed in adult migraineurs as well as in a few clinical studies conducted in pediatric patients. The risk of migraine was also suggested to increase with increasing obesity in children.
#1 Headache in Children and Adolescents
https://pmc.ncbi.nlm.nih.gov/articles/PMC9455826/
If ibuprofen is insufficient, a triptan can be considered. […] Preventive treatment should be considered in all children who have frequent headaches or significant headache-related disability, or both. […] Children with recurrent headaches have approximately double the likelihood of recurrent headaches in adulthood and also have increased likelihood of having other physical symptoms and psychiatric comorbidities.
#1 Headache – Child Neurology Foundation
https://www.childneurologyfoundation.org/disorder/headache/
In rare cases, a headache can be a symptom of a more serious illness. […] Seek prompt medical care if: The child has any of the symptoms above in addition to headaches. […] Most headaches do not seriously affect a child’s function at school or play. Tension headaches usually affect function less than migraine headaches. But if either type of headache is very frequent or severe, it can start to cause problems. If untreated, this can eventually cause severe disability and affect the whole family. […] This is why it is important to work with a child’s doctor to come up with an effective treatment plan as soon as possible. Headaches can become more difficult to control the longer they go untreated. In addition, studies have shown that early treatment leads to a better lifelong outcome.
#1 Frontiers | Management of Childhood Headache in the Emergency Department. Review of the Literature
https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2019.00886/full
The management of headache in the ED depends on the patient’s general conditions and the presumable cause of the headache. […] Headache disorders are the main cause of absence from school, affecting negatively school performance, as well as other daily activities. […] The incidence of headache is variable according with age (3â8% of children aged 3 years, 19.5% of children aged 5, and 37â51.5% of children aged 7). […] Non-traumatic headaches represent 0.7% to 2.6% of visits in a pediatric ED. […] The most common recurrent headache in childhood is migraine, while tension headaches prevail in adolescence. […] Differential diagnosis of pediatric headache in the ED includes a variety of benign causes and viral infections, sinusitis, migraine, and post-traumatic headaches are the most common diagnoses.
#1
https://chiro.org/Graphics_Box_PEDS/ABSTRACTS/Headaches_in_Children_Part_2.shtml
Headaches in children are common and the prevalence is increasing worldwide. The phenotypes of headaches change throughout growth and development making differential diagnosis a challenge. […] Early intervention addressing the chemical, mechanical and psychological factors contributing to an individuals headache is essential. This reduces the risk for central sensitization associated with chronicity and disability including the risk for headache in adulthood. […] Headache prevalence and the prevalence of frequent headaches in children is increasing worldwide. […] The World Health Organization recognizes headaches as a common disorder of the nervous system. A primary headache is one that is intrinsic to the nervous system and not caused by a secondary problem. […] The phenotypes of headaches differ between adults and children due the differences in myelination and cerebral maturation.
#1 Posttraumatic Headache in Children
https://practicalneurology.com/diseases-diagnoses/child-neurology/posttraumatic-headache-in-children/31659/
Headache is the most common symptom experienced after a head injury in both the acute and chronic periods. […] The International Classification of Headache Disorders (ICHD-3) defines PTHA as a headache beginning within 7 days of injury or resumption of consciousness after a traumatic head injury. […] Headache is the most common symptom reported by children and adolescents after head trauma. […] Several studies have attempted to characterize who will go on to develop more significant, chronic headaches after head trauma. […] The wide variety of presentations of PTHA suggests that there may be multiple underlying mechanisms of headache after head injury. Acute headache is presumed to be a direct result of the associated head trauma. However, the mechanism underlying chronic posttraumatic headache symptoms is more ambiguous and has been speculated to involve significant biochemical shifts. More specific mechanisms are yet to be elucidated.
#1
https://www.jpccr.eu/Migraines-in-childhood-as-a-cause-of-headache-in-adulthood-how-to-prevent-it-A-literature,181524,0,2.html
Migraine is the most common acute and recurrent headache in children. The pain is the result of stimulation of meningeal nociceptors. There may be a genetic predisposition to generalized neuronal hyperexcitability. Aura is caused by the cortical spreading depression (CSD). […] In the diagnosis of migraine in paediatric patients, particular importance is attached to a thorough clinical history. Paediatric patients suffering from migraine have a reduced density of grey matter in the frontal cortex. […] There are reports in the literature that migraine occurring in children becomes a risk factor for migraines in adults. Migraines in children represent a difficult disease entity, both diagnostically and therapeutically. To-date, no significant changes have been demonstrated on imaging studies in children and the symptoms themselves may be uncharacteristic. Further research is needed to consider and implement the use of new drugs.
#1 Patient education: Headache in children (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/headache-in-children-beyond-the-basics
The headache is usually deep, excruciating, continuous, and explosive in quality. Cluster headaches commonly include autonomic changes, such as eye redness and tear production on the same side on which the pain occurs, a stuffy and runny nose, sweating, a pale appearance, and possibly drooping of the eyelid. […] Migraine is a disorder of episodic attacks, with headache being one of the symptoms. Migraine can include other episodic disorders (eg, childhood periodic symptoms or episodic symptoms associated with headache). […] The treatment of headaches depends upon the child’s age, the type and frequency of headaches, and other factors. […] The need for an imaging test depends upon the individual child’s signs and symptoms, physical examination, and medical history. However, most children with a headache who have a normal physical examination will not require an imaging test, such as an MRI (magnetic resonance imaging) or a CT (computed tomography) scan. […] The choice among these treatments will depend upon the age and characteristics of the individual child.
#1 Headache in Children and Adolescents
https://pmc.ncbi.nlm.nih.gov/articles/PMC9455826/
The presence of aura and associated dizziness increases with age. […] Studies have demonstrated that adverse experiences in childhood (financial stress; physical, emotional, or sexual abuse; parental divorce; death; mental illness; or addiction) predispose to headache in childhood as well as later in life. […] It is important to know what the child does not have as well as what the child does have. Life-threatening causes such as brain tumors occur in approximately 2% to 3% of children who present to the emergency department for headache and in about 1% of children with headache seen in primary care. […] The majority of children who present to the neurologist will have a primary headache disorder, the features of which are described in this section. […] The guidelines recommend ibuprofen 7.5 mg/kg to 10 mg/kg be used as first-line treatment for all children and adolescents.
#1 Headaches – Kids Plus Pediatrics
https://www.kidsplus.com/parent-resources/doctors-notes/headaches/
For those with anxiety, depression, or significant stress, seeking support from a mental health provider is very helpful. […] If the headaches become more severe and/or frequent […] A new or different kind of severe headache, with change in attack frequency or severity. […] For identification of the type of headache your child might be having, if your child has any of the red flags, or if the treatment prescribed by your pediatrician isnt working, come see us in the office to discuss the headaches.
#2 Patient education: Headache in children (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/headache-in-children-beyond-the-basics
Headaches are a common complaint in children and adolescents, occurring in up to 75 percent of school-aged children. The frequency of headaches is greater in adolescents than in younger children. There are many possible causes of headaches, from common and nonharmful to rare but serious conditions. […] The most common types of primary headaches in childhood are migraine and tension-type headaches, while the most common secondary headaches are associated with an infectious illness or are related to head injury. […] Headaches may be an associated symptom of a systemic infection or may be directly due to a localized infection of the brain or surrounding tissues. A key feature of headache related to an infection is that when the infection gets better, the symptoms of headache should get better, too.
#2 Headaches in Children – Stanford Medicine Children’s Health
https://deprod.stanfordchildrens.org/en/topic/default?id=headaches-in-children-90-P02603
A headache is pain or discomfort in one or more areas of the head or face. Headaches are often divided into 2 groups, based on what causes them: Primary headaches. These are not linked to another health condition. They are usually caused by tight muscles, widened (dilated) blood vessels, changes in nerve signals, or swelling (inflammation) in parts of the brain. […] Secondary headaches. These are a less common type of headache. They are caused by a problem in the brain, or another health condition or disease. […] Researchers dont fully understand the exact cause of headaches. Many headaches may be caused by tight muscles and widened (dilated) blood vessels in the head. Stress and mental or emotional conflict can trigger tension headaches. Migraine headaches may be caused by changes in brain chemicals or nerve signals.
#2 Headaches in Children – Stanford Medicine Children’s Health
https://www.stanfordchildrens.org/en/topic/default?id=headaches-in-children-90-P02603
Headaches of any type that come back again and again (recurrent) can cause: […] Primary headaches are not linked to another health condition. They are usually caused by tight muscles, widened (dilated) blood vessels, changes in nerve signals, or swelling (inflammation) in parts of the brain. […] Secondary headaches are the least common type of headaches. They are caused by a problem in the brain, or another health condition or disease.
#2 Annals of Child Neurology
https://www.annchildneurol.org/m/journal/view.php?number=1372
Pediatric headache is a common condition that often results in frequent outpatient visits. […] The management of migraine focuses on lifestyle modifications, behavioral therapy, and pharmacotherapy for acute episodes and long-term preventive therapy. […] The pathophysiology of headaches is intricate, with genetic and environmental factors playing crucial roles in the development of migraine, tension-type headache, and cluster headache. […] The vascular theory of migraines, according to which migraine stems from blood vessel dilation and that the aura is a result of vasoconstriction, is now deemed invalid, as evidenced by magnetic resonance angiography studies. […] A typical migraine episode consists of four phases: the prodromal or premonitory phase, the aura phase, the headache phase, and the post-dromal phase.
#2 What causes migraine headaches in children? | Norton Children’s Louisville, Ky.
https://nortonchildrens.com/news/causes-migraine-headaches-in-children/
Kids can experience migraine just like adults do, and if you experience migraine, you know how helpless you can feel until it passes. […] Migraine is more than just a âbad headache.â Itâs a complicated neurological disease, with severe head pain and other symptoms including nausea and vomiting; dizziness; and sensitivity to touch, sound, light and odors. […] Identifying the triggers that could be causing your childâs migraine headaches are important, said Elizabeth S. Doll, M.D., pediatric neurologist with Norton Childrenâs Neuroscience Institute. […] The causes of migraine headaches can vary, but avoiding certain triggers can be helpful when it comes to managing episodes. […] Another risk factor includes a family history of migraine. If one parent has migraine, the child has a 50% chance of inheriting them. The risk goes up to 90% when both parents have a history of migraine.
#2 Annals of Child Neurology
https://www.annchildneurol.org/m/journal/view.php?number=1372
The migraine aura constitutes a reversible neurological phenomenon impacting approximately one-third of all migraine sufferers and occasionally overlapping with the headache phase. […] The underlying mechanism of this phase is thought to involve cortical spreading depolarization (CSD) across the cortex. […] The headache phase is characterized by the activation of the trigeminocervical complex. […] Neuropeptides, particularly calcitonin gene-related peptide (CGRP), are involved in trigeminal activation and have emerged as a potential target for therapeutic interventions in migraine patients. […] The development of cluster headaches involves interactions among the trigemino-vascular pathway, trigeminal autonomic reflex, hypothalamus, and the neuropeptides CGRP and pituitary adenylate cyclase-activating polypeptide. […] In tension-type headaches, the pain is thought to stem from myofascial structures and is heightened by central sensitization mechanisms.
#2 Patient education: Headache in children (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/headache-in-children-beyond-the-basics
The headache is usually deep, excruciating, continuous, and explosive in quality. Cluster headaches commonly include autonomic changes, such as eye redness and tear production on the same side on which the pain occurs, a stuffy and runny nose, sweating, a pale appearance, and possibly drooping of the eyelid. […] Migraine is a disorder of episodic attacks, with headache being one of the symptoms. Migraine can include other episodic disorders (eg, childhood periodic symptoms or episodic symptoms associated with headache). […] The treatment of headaches depends upon the child’s age, the type and frequency of headaches, and other factors. […] The need for an imaging test depends upon the individual child’s signs and symptoms, physical examination, and medical history. However, most children with a headache who have a normal physical examination will not require an imaging test, such as an MRI (magnetic resonance imaging) or a CT (computed tomography) scan. […] The choice among these treatments will depend upon the age and characteristics of the individual child.
#2 Headaches in children – Symptoms & causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/headaches-in-children/symptoms-causes/syc-20352099
Headaches in children are common and usually aren’t serious. Like adults, children can develop different types of headaches, including migraines or stress-related (tension) headaches. Children can also have chronic daily headaches. […] In some cases, headaches in children are caused by an infection, high levels of stress or anxiety, or minor head trauma. […] Doctors use the phrase „chronic daily headache” (CDH) for migraines and tension-type headaches that occur more than 15 days a month. chronic daily headache (CDH) may be caused by an infection, minor head injury or taking pain medications even nonprescription pain medications too often. […] A number of factors can cause your child to develop headaches. Factors include: […] Emotional factors. Stress and anxiety perhaps triggered by problems with peers, teachers or parents can play a role in children’s headaches.
#2 Headache in Children: Selected Factors of Vascular Changes Involved in Underlying Processes of Idiopathic Headaches
https://www.mdpi.com/2227-9067/7/10/167
Recent data suggest that some risk factors for atherosclerosis and platelet aggregation (i.e., brain-derived neurotrophic factor (BDNF), sCD40L (soluble CD40 ligand), serpin E1/PAI I (endothelial plasminogen activator inhibitor), and vascular endothelial growth factor (VEGF)) may be involved in the underlying processes of idiopathic headaches. […] The knowledge on the correlation between headaches and factors, which may increase the risk of atherosclerosis, and consequently, premature coronary artery disease, may be of particular importance, especially in the pediatric population. […] A number of risk factors for headache have been demonstrated. Predisposition to atherosclerosis in idiopathic headaches seems to be particularly important from the clinical point of view. Migraine was suggested to be one of the first signs of disorders in lipid metabolism. Elevated lipid concentrations were widely observed in adult migraineurs as well as in a few clinical studies conducted in pediatric patients. The risk of migraine was also suggested to increase with increasing obesity in children.
#3 Migraine in Children | American Migraine Foundation
https://americanmigrainefoundation.org/resource-library/migraine-children/
Migraine in children can sometimes be difficult to spot. Thereâs no blood or bruises, no fever or chills, no broken bonesâbut the pain can be immense. […] Almost 60 percent of children complain of headache at some point. On top of that, about 10 percent of children experience the pain and disability of migraine. Migraine is not just a headache; itâs a disabling neurological disease that affects people of all ages. […] Although migraine in children is the same disease that affects adults, it can impact children in different ways. Knowledge of the disease allows parents to help their child manage triggers and explore treatment options. […] Migraine is hereditary, so if one or both parents has migraine, there is a 50-75% chance their child will be affected. Knowing their familyâs medical history, especially if it involves migraine, can help younger generations get an early and accurate diagnosis.
#3 Headaches in children – Symptoms & causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/headaches-in-children/symptoms-causes/syc-20352099
Genetic predisposition. Headaches, particularly migraines, tend to run in families. […] Problems in the brain. Rarely, a brain tumor or abscess or bleeding in the brain can press on areas of the brain, causing a chronic, worsening headache. Typically in these cases, however, there are other symptoms, such as visual problems, dizziness and lack of coordination.