Treatment of headache in children. Deviation from the norm of intracranial pressure. Head and Brain Injury

It is generally accepted in society that headaches in children are an extremely rare problem. But this is not the case. Excessive mental and physical stress, stress, conflicts at school, unhealthy diet - an incomplete list possible reasons health problems.

The child has a headache and high temperature, vomiting, dizziness is observed in infectious diseases, organic brain lesions. Therefore, a doctor's consultation is mandatory even with minimal complaints of pressing, dull pain in the forehead, occiput, and temples. A timely visit to the hospital will help identify the cause of the ailment and eliminate it.

Headache in children occurs at any age, even newborns may have this symptom. Diagnosis in this case is difficult, since the child does not know how to speak. It is quite difficult to determine the localization of unpleasant sensations.

There are some age features headaches:

In newborns, children under one year old, headache is associated with birth trauma. , the use of forceps, vacuum, prolonged anhydrous period can lead to high blood pressure inside the skull. If during childbirth there were, and the baby behaves restlessly, cries, sleeps poorly, consultation with a neurologist is necessary.
In a child aged 3 years, headache often occurs against the background of colds, infectious diseases. Due to intoxication, the body temperature rises, vomiting, nausea appears.
When a child starts school, his life changes dramatically. You need to get up early, learn homework, complete assignments. The student finds himself in a new team, where it is necessary to build relationships with peers, teachers. All this is a lot of stress for him. In a child over 6 years of age, the headache is more often of a functional nature, associated with overwork, disturbed sleep, nutrition.
The second peak occurs during adolescence. One of the reasons are hormonal changes... The model of behavior is changing, there are problems in communicating with parents and friends. In a 12-year-old child, the headache is stressful.

Despite age characteristics, there are many reasons that cause pain in the frontal, occipital or temporal part of the head. Particular attention should be paid to concomitant symptoms, localization of unpleasant sensations, the time of their occurrence.

The main causes of headaches in children are:

Overstrain, stress.
Violation of the vascular tone of the brain.
Infectious diseases. Cold headache in a child is common, but it can also be a symptom.
Vision problems. Prolonged tension of the eye muscles, incorrectly selected glasses lead to a headache in the forehead in the child.
Head injuries, bruises, fractures.
Sleep disturbance. Both short and excessively long sleep is negatively affected.
Migraine is the cause of headaches in children over 11 years of age.
Diseases of the ENT organs -,.
Being in a poorly ventilated area leads to oxygen starvation the brain, as a result - to drowsiness, pressing headaches in the back of the head.
Improper nutrition. Skipping meals, especially in the morning, can cause hypoglycemia. In this case, the leading symptoms of the child will be dizziness and headache. In severe cases, loss of consciousness is possible.
Neoplasms in the brain (tumors, cysts, abscesses) are characterized by the occurrence of unpleasant sensations in the frontal, occipital, temporal lobes.

Clinical manifestations

Headache symptoms in children are varied. To make a correct diagnosis, it is necessary to take into account the accompanying manifestations: fever, nausea, vomiting. Also, an important role is played by the time of the appearance of unpleasant sensations, their localization. By bringing all the manifestations together, you can identify the leading syndrome or disease.

Vascular headache

The brain needs adequate amounts of nutrients and oxygen to function properly. Due to dysregulation, constant stress arteries spasm or excessive stretching occurs. The brain tissue is highly responsive to such changes. This type of headache can occur in a child over 10 years old. In adolescence, this will lead to the development of vascular dystonia.

Increase or decrease in intracranial pressure

The pressure of the cerebrospinal fluid (cerebrospinal fluid) can increase normally during exercise, straining, coughing, lifting heavy objects. Clinically, this condition does not manifest itself in any way, the indicators quickly return to normal. Seek medical attention if symptoms occur. In most cases, high intracranial pressure indicates pathology.

Main manifestations:

Headache and nausea in a child are the leading complaints.
The condition worsens at night, in the evening.
Nausea often ends with vomiting. It does not provide relief, unlike diseases of the digestive system.
Headache with increased intracranial pressure in children is localized in the back of the head, unpleasant sensations may appear in the eye area due to the pressure of the cerebrospinal fluid on the orbits.
Sleep disturbance, anxiety, tearfulness.

A decrease in intracranial pressure occurs against the background of head injuries, dehydration. It is difficult to judge a headache in a child under 5 years old. Children often cannot assess the nature, localization of unpleasant sensations. Therefore, it is necessary to pay attention to the following manifestations: weakness, drowsiness, apathy, loss of consciousness, dizziness. The headache is dull, pressing in nature, in most cases, children point to the back of the head.

With infectious diseases

Headache in inflammatory diseases never occurs on its own. Parents note a fever in the child, chills, nausea or vomiting, sore throat, nasal congestion, and other manifestations. In such a situation, it is much easier to make a diagnosis, the totality of manifestations indicates a specific disease.

Meningococcal infection

This disease occurs in children under one year old, also in senior school age. The child has a fever and a severe headache. Later, vomiting appears, it is not associated with eating, does not bring relief. The patient's condition deteriorates sharply. Children take a forced position: the child lies on its side, the legs are brought to the chest, the head is thrown back.

If the above symptoms occur, the meningeal signs should be checked. Attempts to tilt the chin to the body are sharply painful, bent at the hip and knee joint the leg cannot be straightened. Also, the appearance of a rash on the trunk and limbs should be alerted. It has a hemorrhagic character, resembles asterisks in shape.

It is strictly forbidden to independently treat headaches in children. Meningococcal infection often occurs with lightning speed, after a few hours the child's condition may be critical.

Acute respiratory diseases

A headache with ARVI in a child is accompanied by a rise in temperature, cough, runny nose, general weakness... Symptoms will differ from one species to another. viral infections.

The main manifestations of the disease are presented below:

Influenza begins abruptly with a temperature rise of up to 40 ° C. The child has a headache in the frontal part, eyes also suffer. The cough joins on the second day of the disease. Weakness, body aches, muscle pains are noteworthy.
With a rhinovirus infection, a runny nose and headache come to the fore in a child. Discharge from the nose is transparent, the general condition is satisfactory.
In diseases of adenoviral etiology, damage to the eyes and intestines is possible.

Tension headache

Stress, excessive mental or physical exertion, bad dream, unhealthy diet affects the health of children. Conflicts with classmates, teachers, quarrels in the family affect the emotional state.

Overstrain is the most common cause of headache in a 7-year-old child. At this age, the lifestyle changes, instead of carefree games, now you need to learn lessons, go to school. Unpleasant sensations arise in the frontal, occipital part, have a dull, aching character, intensify towards the end of the day.

Migraine

Migraine in childhood has its own characteristics:

Family history - One of the parents has similar symptoms.
The child complains of a throbbing, pressing headache on one side.
The duration of the attack is shorter than in adults.
Digestive disorders are often observed - vomiting, nausea, loose stools.
Migraine is closely related to emotional sphere, occurs during stress, overwork. In a child over 9 years old, especially in adolescence, the headache is explained by hormonal changes.

Trigeminal neuralgia

Nerve inflammation is rare in pediatric practice. The symptoms are quite specific, so there are no difficulties with the diagnosis. Manifestations depend on the location of the damage. With inflammation of the orbital branch, the child will experience a sharp headache in the forehead. When touching the brow ridges, cheeks, chin, discomfort intensifies. The pain is sharp, shooting, becomes unbearable over time. It has a periodic character, periods of exacerbation last several minutes, then a period of rest begins.

CNS damage

If a child often complains of a headache, the clinical picture is atypical for other diseases, a neurologist may prescribe magnetic resonance imaging to exclude masses of the brain. Tumors, cysts, hematomas lead to the occurrence intracranial hypertension... In this case, the child has a severe headache and vomiting. Over time, visual impairment, loss of sensitivity, and epileptic seizures may appear.

Localization

Headache in the forehead area occurs with inflammation of the maxillary, frontal sinuses, acute respiratory viral infections, in particular with influenza. Meningitis is accompanied by discomfort in the forehead. The sharpest pain in the superciliary arch is observed with inflammation of the trigeminal nerve.

With migraine, cephalalgia occurs on one side, more often in the temporal region. Similar localization of pain with increased intracranial pressure, head injuries. During nervous tension, stress, discomfort occurs near the temples, eventually spreading to the back of the head.

Features of headache in young children

In infants, the presence of a headache can be judged only indirectly, the child does not yet know how to speak, does not understand the request. Crying, anxiety, and poor sleep may indicate health problems. First of all, you need to check if the baby is hungry, if he is dry. If the child's condition does not improve, it is recommended to visit the attending physician. After the examination, the doctor will identify the reason for this behavior, advise what children can get from headaches at this age, and which drugs are better to refuse.

Features of headaches in children under one year old:

Anxiety, crying, screaming, the condition worsens in the evening.
The child holds his hands near his head, can pull his hair.
Both daytime and nighttime sleep is disturbed.
Regurgitation, vomiting are observed.
An increase in temperature indicates an inflammatory process.
Swelling of the fontanelle, head veins indicates increased intracranial pressure.

Symptoms in older children are similar to those in adults. The clinical picture depends on the cause of the disease. The child can clearly indicate the localization of pain, say when it occurs, what it is associated with, how long it lasts, which facilitates the diagnosis.

First aid

If a child develops a headache, the temperature is 38 ° C or higher, it is necessary to call a doctor.

You also need to ask for help in the following cases:

A child's headache is accompanied by vomiting, severe nausea.
The onset of seizures.
Bleeding from the nose that does not stop.
Injuries, bruises of the head.
In children under one year old, a doctor's call is mandatory when the first symptoms occur.

Before the arrival of an ambulance, the child must be put on the bed, provide access to fresh air, close the curtains, remove possible irritants: bright light, sound, strong odors.

What can children do for headaches? These are Ibuprofen and Paracetamol. The dosage depends on age, it is calculated per kilogram of mass, therefore, you must carefully read the instructions before use.

Diagnostics

The diagnosis consists of the following steps:

The doctor identifies the main symptoms. The child may complain of headache, weakness, nausea, vomiting, fever.
Further, the doctor asks clarifying questions - when the pain occurs, at what time of day, how it is provoked, how long it bothers, it goes away on its own or after the use of drugs.
It is necessary to ask the little patient about school, relationships with friends, relatives. In a child over 8 years old, headache may be associated with overstrain.
The next stage is inspection. The pediatrician checks reflexes, measures temperature, examines the skin, pharynx.
If necessary, appointed additional methods examinations: blood test, urine analysis, X-ray of the skull, cervical spine, MRI, throat swab.

Treatment

Patient management tactics depend on the cause of the disease. Many mothers are interested in what kind of headache pills children can use. If a single headache occurs in a child 4 years of age or older, the use of Ibuprofen or Paracetamol is allowed. The dose can be calculated independently, taking into account weight and age, or consult a doctor.

In some cases, the use of drugs is not required, it is enough to change the daily regimen, reduce the load, and the condition will improve.

Tension headache in a child is treated quite simply. Parents are advised to provide the child good nutrition, healthy sleep, spend more time outdoors, reduce the student's workload, allow him to rest more. Medicinal products have a calming effect. herbal teas based on chamomile, lemon balm, mint.

If the cause of the deterioration is infectious processes, treatment will include antibiotics, symptomatic therapy... In case of detection of tumor formations, a consultation with a neurosurgeon is indicated.

Before treating a child's headache, it is necessary to identify its cause. This can be both ordinary fatigue and serious pathology. Therefore, if you experience discomfort in the forehead, back of the head or temples, it is recommended to consult a specialist.

Useful video about the causes of headaches in a child

Answer

Acute or chronic headache is familiar to many people, in particular children suffer from it. By the nature of the manifestations, the pain is different: pulsating, acute, aching, shooting, localizes one or another part of the head. Why does the occipital part hurt in a child, and how to get rid of unpleasant symptoms, we will consider in more detail?

What reasons?

There can be many reasons. It is not so scary if the child has soreness for the first time due to overstrain of the muscles and soft tissues of the neck after a long stay of the head in one position. But, the back of the head is directly related to the spine (cervical spine) and the causes of pain can be more unpleasant. So, everything is in order.

If a child complains of compression of the head, pain in the temples and forehead, then the reason may be increased intracranial pressure, changes in the vessels of the brain, or as a result of a recent sore throat, flu.

It is important to recognize in time the nature of the pain in the back of the head in a child. With its strengthening when turning the head to the sides, a protracted course, the development of osteochondrosis (spondylitis) is possible.

If the neck muscles are compacted, then this is a consequence of curvature of posture or muscle overexertion after a long stay in an uncomfortable position. The child may simply be blown out in a draft and pain is a symptom that not everything is in order in the cervical spine.

Common causes of back pain are brain injuries. If the child fainted immediately after the impact, then this is a clear sign of head injury. Symptoms often resolve quickly. The kid will cry a little, calm down and quickly forget about the trouble. But he may start to be capricious again after some time, which should certainly alert parents, especially if the head pains are strong, it is dark before the eyes.

The consequences of the blow did not pass without a trace, when the fontanelle swelling in infants, the head tilting back with an arching of the back became more frequent. If the baby has already hit his head, then you need to lay him down, isolate him from bright light getting into his eyes and rub the bruised area with your palms slightly, apply a cold compress. For a while, protect the child from unnecessary noise, outdoor games. With the appearance of nausea, vomiting, signs of cerebral hemorrhage in children, of course, you need to see a doctor immediately.

Diseases causing pain

Migraine. Increased pain during coughing, sneezing may indicate neuralgic diseases. The most common of them, even in childhood, is migraine.
Heart - vascular diseases as a result of circulatory disorders in the brain. There is oxygen starvation, a sharp narrowing of blood vessels, blood pressure jumps, hypertension develops and, as its main symptom, pain in the back of the head. Hypertension can be provoked by a hereditary factor, a sharp change in the weather, and sleep disturbance. With mild hypertension, the symptoms in children quickly pass, it is enough just to walk in the fresh air, to establish a diet and sleep. If the case is severe and pain in the back of the head has become a constant phenomenon, then you need to see a neurologist, undergo the prescribed treatment (pathological changes are possible in the vessels).
Neuralgia, a headache due to damage to the trigeminal nerve, shocks like an electric current, often repeats, but quickly passes. When coughing, sneezing, sharp turns of the head intensifies, the muscles on the face may twitch (involuntarily contract). Neuralgia occurs when there are malfunctions in the cervical spine, against the background of a cold, an outbreak of an infectious disease. To eliminate troubles, heating, UHF, applying a bag of heated sand and warm compresses or cabbage leaves (plantain), and gauze soaked in juice are rare to the occipital area. It is good to give children an infusion of wormwood yarrow. Many problems with cervical vertebrae become the result of improper posture of the child, which is important to monitor to teach children with early childhood... The neck is well supported by a cushion during sleep, which should be placed instead of a pillow, and the bed should also be firm enough.
Migraine, according to experts, is in most cases a hereditary ailment, usually transmitted from the mother. The likelihood of migraine in children is high if the mother herself suffers from it. This disease is associated with a lack of serotonin in the brain, which actually leads to throbbing pains, nausea and dizziness. It is unlikely that a complete cure of migraine is possible in the event of its inheritance, but it is possible to block and relieve attacks immediately when they appear: often ventilating the room, staying in the fresh air. Children can be given freshly squeezed juice of potatoes (2 tablespoons 2-3 times a day), viburnum, black currant (juices), massage the head and the back of the head.
Cervical osteochondrosis, abrasion of the vertebrae of the neck and intervertebral discs... Reasons for development - sedentary sedentary image life, smoking, overweight everything, genetic predisposition, improper posture during sleep. It hurts in the neck and back of the head. It is necessary to treat the disease, the processes of degeneration in the cervical spine in a child can ultimately lead to irreversible consequences.
Cervical spondylosis, there is deformation of the vertebrae in the neck, the appearance of osteophytes - growths that cause pain when turning the head, torment especially at night, do not go away even at rest. From increased tension in the cervical zone, in addition to pain in the back of the head, it puts pressure on the eyes and ears. More often, the disease occurs in the elderly or those leading a sedentary lifestyle.
Cervical myositis, a manifestation of an inflammatory reaction in the muscles of the skeleton of the spine, leading to damage to one of the groups of bones. This is an internal pathology, but with manifestations on the skin, regression of dermatomyositis is possible due to hypothermia, early injuries or muscle sprains, and infectious diseases. It hurts first in the neck area, then begins to move to the back of the head. Only treatment at an early stage of the disease gives positive results. According to the results X-ray examination anthelmintic, anti-inflammatory, antibacterial agents are prescribed. Shown are massage, physiotherapy.

What external factors can lead to pain in the back of the head?

Young children cannot express signs of anxiety in words, they just start to be capricious and cry. In fact, parents need to be attentive. A lack of air in the room, a bright sound, light, and even a long stay during sleep in one position, when the neck muscles become numb, can cause discomfort in the back of the head. TV can become an irritant factor. loud noise or scented candles placed in front of the baby's bed. Aromatherapy has a powerful effect on the body and the effect should be relaxing, calming. But nevertheless, if the baby is capricious from the light directed into the eyes, and he does not like it, then it is better to remove and take a closer look in silence and in the dark he will fall asleep faster.

Neck pain in a child may appear due to an improper bite and difficulty chewing food with an incorrect position of the teeth. This affects speech, gums, and pain in the back of the head is also manifested. In addition, headache occurs in children under 5 years of age, and can be triggered by the intake of certain foods. Foods with a high content of nitrites and preservatives lead to vasoconstriction and spasms, as a result - to a headache in the back of the head. Harmful substances are found in food additives, for example, tyramine, sodium nitrite, which can cause headaches, low blood sugar. They have a bad effect on the brain and its functions, fail. If such phenomena were observed in the mother during pregnancy, then there is a high probability that the child will suffer from headaches from birth.

In case of poisoning with poor-quality food (except for headaches), children may experience nausea, vomiting, and diarrhea due to indigestion. It is important to prevent dehydration, more often to water the child with broths, tea with the addition of mint, St. John's wort, elderberry. If the neck area hurts with attacks, then you can prepare an infusion of birch leaves by brewing 1 tbsp. 1 cup boiling water, let it brew for 2-3 hours, apply to the affected area.

If the child is predisposed to pain in the head and occiput with attacks, it is necessary to exclude food rich in carbohydrates from the diet, feed the child more often (up to 5 times a day), but in small portions.

Output

Children are impulsive, emotional, unable to cope with psychological problems and stress. Negative emotions negatively affect the brain, causing headaches that can be violent, violent, monotonous, or prolonged. Analgesics and sedatives do not always help to cope with pain with severe overexcitation.

It is hardly possible to protect your child from everyone negative factors acting on the brain from the outside, but the development of protective reactions of the body must be constantly taught. A child should not keep fears, doubts and experiences in himself, but throw them out in time due to the groundlessness of such types of anxiety. It is important to explain this so that the baby believes and quickly calms down.

The child has a headache from behind, what is the reason?

Headache is one of the most common symptoms people encounter most often. What to do. if the child has a headache from behind? What are the reasons for this? How to treat head pain in a child?

Headache is one of the most common symptoms people encounter most often. More than 80% of the population of the civilized countries of America and Europe suffers from chronic or acute headaches.

What can cause a headache?

A headache in the back of the head can begin for various reasons. This shows a sign of both a serious ailment and a consequence of an extended head in an awkward position.

The insidiousness of this pain lies in the difficulty of distinguishing the true pain in the back of the head from the loma in the neck, because in many cases the child has a headache from behind due to a disease of the cervical spine, for the same from the strain of the neck muscles.

Causes

Diseases of the cervical spine (spondylitis, osteochondrosis, sprains, etc.) - lingering pain, aggravated by turning.

Thickening of the neck muscles - as a result of improper posture, being in a draft, nervous strain, prolonged awkward posture, etc.

Neuralgia of the occipital nerve is a sharp and unbearable pain when coughing, rapid head movement, sneezing.

Injuries to the cervical spine and head.

Treatment

Treatment of pain in the head in a child is associated with the elimination of the causes of the malaise. In case of neck injuries - neck fixation occurs orthopedic collar... When muscles are tightened, massage is intended (up to 10 sessions). This massage uses warming massage oils or oils that contain menthol.

If your head aches from cervical osteochondrosis- visit required physiotherapy exercises and taking vitamins that contain calcium.

In each case, if you experience severe headaches from behind, you should consult a doctor. But most best recommendation will be - monitor the baby's health so that he gets less cold and is not in a draft. Under an hour of long-term work in one position (at the computer, etc.), it is necessary to do exercises, warm-ups so that muscle overstrain and blood stagnation do not begin.

Why do children have a headache?

Such a common ailment as headache rarely bothers children. However, even if such a problem arises in a child, it cannot be solved by using analgesics, as is allowed in the situation with adults. If children have a headache, it should be treated differently.

The thing is that it is quite difficult to recognize this ailment in babies. If you notice some anxiety in your child, you need to exclude other causes, for example, colic, wet diapers or hunger. Then you need to pay attention to the accompanying symptoms. So, if children have a headache, the crying of babies is distinguished by a certain excitement. The child squints and shakes his head. In infants, in this case, frequent regurgitation and some disturbance in sleep patterns may appear.

If a similar condition occurs in a child who can describe his condition, it becomes somewhat easier to help the baby. However, not all children can correctly understand what exactly hurts them, therefore this should also be treated with attention.

If children have a headache, it may be associated with migraine attacks. As a rule, a similar disease can manifest itself in children aged 3-5 years. This disease is considered hereditary, and the mechanism of its formation is not fully understood. An attack can be triggered by a drop in atmospheric pressure, overexertion, or even eating certain foods (for example, chocolate, nuts, or cheese). This condition provokes vomiting in the child, after which, as a rule, it becomes easier for the baby. After sleep, the attack usually goes away.

This disease is not dangerous, but it is difficult to tolerate and frightens the child. In this case, if the child constantly has a headache, you need to put him in a darkened room, give him strong green tea with sugar, massage his temples and the back of his head with an ointment that warms. Sometimes this condition is accompanied by diarrhea and vomiting.

When such a symptom appears, it is imperative that the child be shown to the pediatrician and neuropathologist.

If a child has a headache, it can be caused by overstraining of the muscles and ligaments of the head, neck and even back, which causes a dull headache, tightening the back of the head. Among the main reasons are called microtrauma of the spine, received during childbirth, jumping or somersaults. Also, the causes of pain can be fatigue and lack of fresh air. If a child is constantly sitting at the computer, this has a detrimental effect on his health. It is imperative to limit the presence of children at the monitors, to devote a lot of time to walking in the fresh air.

When a child has a headache, back of the head, or temporal lobe, this may indicate the presence of another disease. For example, these symptoms can be associated with ARVI, influenza and meningitis.
Also, a headache may appear when the vascular tone changes. If the baby is less than 2 years old, this may be the result of a change in intracranial pressure. The risk group also includes those children who have suffered a birth trauma or hypoxia.

In any case, only a specialized examination can establish the cause of the headache in children. Therefore, parents should not do anything without consulting a specialist.

Why does the head hurt in the back of the head

We can say that every person in his life has ever faced pain in the back of the head. Why does the head hurt in the back of the head? What kind of pain in this place can be:

# 8212; pressing pain;
# 8212; Blunt pain;
#8212; sharp pain;
# 8212; constant;
# 8212; pulsating;
# 8212; episodic pain.

The type of pain that excruciates depends largely on the cause of the disease. In any case, the one who has a headache wants to get rid of it as soon as possible. The choice of how to deal with pain depends on the causes that caused it in the back of the head.

Headache in the back of the head

The most common causes of back pain are:

# 8212; increased intracranial pressure;
# 8212; muscle tension;
# 8212; diseases of the cervical muscles (myogilosis and myositis);
# 8212; spasm of blood vessels of the brain;
# 8212; neuralgia of the occipital nerve;
# 8212; being in an uncomfortable position for a long time;
# 8212; diseases of the cervical spine (neck migraine, osteochondrosis, spondylitis).
# 8212; diseases in the temporomandibular joints, impaired bite.
# 8212; high blood pressure.
# 8212; stress.

Treatment of back pain

We examined why the head hurts in the back of the head, now we will find out how to treat it. Before treatment, it is necessary to find out the causes of pain in the back of the head. First you need to go for a consultation with a local therapist. If necessary, he gives a referral for a more complete examination by other specialists: an exercise therapy doctor, a traumatologist and a neurologist.

After establishing the cause of pain in the back of the head, treatment is prescribed, during which control of the general condition of the body and prevention is necessary. It is unacceptable to overcool or be in a draft.

Hard massage often helps, however, with blood pressure accompanied by a headache, such massage is contraindicated.

If headaches in the back of the head occur due to the development of hypertension, then constant monitoring and measurement is necessary. blood pressure to prevent it from being lifted.

Must be avoided stressful situations and excitement, you need to lead a measured and calm life.

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Sources:

It is generally accepted in society that headaches in children are an extremely rare problem. But this is not the case. Excessive mental and physical exertion, stress, conflicts at school, unhealthy diet - an incomplete list of possible causes of health problems.

The onset of headache and high fever, vomiting, dizziness in a child is observed in infectious diseases, organic brain lesions. Therefore, a doctor's consultation is mandatory even with minimal complaints of pressing, dull pain in the forehead, occiput, and temples. A timely visit to the hospital will help identify the cause of the ailment and eliminate it.

Causes

There are some age-related features of headaches:

In newborns, children under one year old, headache is associated with birth trauma. Asphyxia, the use of forceps, a vacuum, a long dry period can lead to increased pressure inside the skull. If there were complications during childbirth, and the baby behaves restlessly, cries, sleeps poorly, consultation with a neurologist is necessary.
In a child aged 3 years, headache often occurs against the background of colds, infectious diseases. Due to intoxication, the body temperature rises, vomiting, nausea appears.
When a child starts school, his life changes dramatically. You need to get up early, learn homework, complete assignments. The student finds himself in a new team, where it is necessary to build relationships with peers, teachers. All this is a lot of stress for him. In a child over 6 years of age, the headache is more often of a functional nature, associated with overwork, disturbed sleep, nutrition.
The second peak occurs during adolescence. Hormonal changes are one of the reasons. The model of behavior is changing, there are problems in communicating with parents and friends. In a 12-year-old child, the headache is stressful.

The main causes of headaches in children are:

Overstrain, stress.
Violation of the vascular tone of the brain.
Infectious diseases. Headache with a cold in a child is common, but it can also be a symptom of flu, meningitis, encephalitis, otitis media.
Vision problems. Prolonged tension of the eye muscles, incorrectly selected glasses lead to a headache in the forehead in the child.
Head injuries, bruises, fractures.
Sleep disturbance. Both short and excessively long sleep is negatively affected.
Migraine is the cause of headaches in children over 11 years of age.
Diseases of the ENT organs - sinusitis, tonsillitis.
Being in a poorly ventilated room leads to oxygen starvation of the brain, as a result - to drowsiness, pressing headaches in the back of the head.
Improper nutrition. Skipping meals, especially in the morning, can cause hypoglycemia. In this case, the leading symptoms of the child will be dizziness and headache. In severe cases, loss of consciousness is possible.
Neoplasms in the brain (tumors, cysts, abscesses) are characterized by the occurrence of unpleasant sensations in the frontal, occipital, temporal lobes.

Clinical manifestations

Vascular headache

Increase or decrease in intracranial pressure

Main manifestations:

Headache and nausea in a child are the leading complaints.
The condition worsens at night, in the evening.
Nausea often ends with vomiting. It does not provide relief, unlike diseases of the digestive system.
Headache with increased intracranial pressure in children is localized in the back of the head, unpleasant sensations may appear in the eye area due to the pressure of the cerebrospinal fluid on the orbits.
Sleep disturbance, anxiety, tearfulness.

A decrease in intracranial pressure occurs against the background of head injuries, intestinal infections, and dehydration. It is difficult to judge a headache in a child under 5 years old. Children often cannot assess the nature, localization of unpleasant sensations. Therefore, it is necessary to pay attention to the following manifestations: weakness, drowsiness, apathy, loss of consciousness, dizziness. The headache is dull, pressing in nature, in most cases, children point to the back of the head.

With infectious diseases

Meningococcal infection

If the above symptoms occur, the meningeal signs should be checked. Attempts to tilt the chin to the body are sharply painful, the leg bent at the hip and knee joint cannot be straightened. Also, the appearance of a rash on the trunk and limbs should be alerted. It has a hemorrhagic character, resembles asterisks in shape.

It is strictly forbidden to independently treat headaches in children. Meningococcal infection often occurs with lightning speed, after a few hours the child's condition may be critical.

Acute respiratory diseases

A headache with ARVI in a child is accompanied by a rise in temperature, cough, runny nose, and general weakness. Symptoms will differ with different types of viral infections.

The main manifestations of the disease are presented below:

Influenza begins abruptly with a temperature rise of up to 40 ° C. The child has a headache in the frontal part, eyes also suffer. The cough joins on the second day of the disease. Weakness, body aches, muscle pains are noteworthy. More about influenza in children →
With a rhinovirus infection, a runny nose and headache come to the fore in a child. Discharge from the nose is transparent, the general condition is satisfactory.
In diseases of adenoviral etiology, damage to the eyes and intestines is possible.

Tension headache

Stress, excessive mental or physical exertion, poor sleep, and poor nutrition affect the health of children. Conflicts with classmates, teachers, quarrels in the family affect the emotional state.

Migraine

Migraine in childhood has its own characteristics:

Family history - One of the parents has similar symptoms.
The child complains of a throbbing, pressing headache on one side.
The duration of the attack is shorter than in adults.
Digestive disorders are often observed - vomiting, nausea, loose stools.
Migraine is closely related to the emotional sphere, it occurs during stress, overwork. In a child over 9 years old, especially in adolescence, the headache is explained by hormonal changes.

Trigeminal neuralgia

CNS damage

If a child often complains of a headache, the clinical picture is atypical for other diseases, a neurologist may prescribe magnetic resonance imaging to exclude masses of the brain. Tumors, cysts, hematomas lead to intracranial hypertension. In this case, the child has a severe headache and vomiting. Over time, visual impairment, loss of sensitivity, and epileptic seizures may appear.

Localization

Features of headache in young children

Features of headaches in children under one year old:

Anxiety, crying, screaming, the condition worsens in the evening.
The child holds his hands near his head, can pull his hair.
Both daytime and nighttime sleep is disturbed.
Regurgitation, vomiting are observed.
An increase in temperature indicates an inflammatory process.
Swelling of the fontanelle, head veins indicates increased intracranial pressure.

First aid

If a child develops a headache, the temperature is 38 ° C or higher, it is necessary to call a doctor.

You also need to ask for help in the following cases:

A child's headache is accompanied by vomiting, severe nausea.
The onset of seizures.
Bleeding from the nose that does not stop.
Injuries, bruises of the head.
In children under one year old, a doctor's call is mandatory when the first symptoms occur.

Before the arrival of an ambulance, the child must be put on the bed, provide access to fresh air, close the curtains, remove possible irritants: bright light, sound, strong odors.

Diagnostics

The diagnosis consists of the following steps:

The doctor identifies the main symptoms. The child may complain of headache, weakness, nausea, vomiting, fever.
Further, the doctor asks clarifying questions - when the pain occurs, at what time of day, how it is provoked, how long it bothers, it goes away on its own or after the use of drugs.
It is necessary to ask the little patient about school, relationships with friends, relatives. In a child over 8 years old, headache may be associated with overstrain.
The next stage is inspection. The pediatrician checks reflexes, measures temperature, examines the skin, pharynx.
If necessary, additional research methods are prescribed: blood, urine, x-ray of the skull, cervical spine, MRI, throat swab.

Treatment

In some cases, the use of drugs is not required, it is enough to change the daily regimen, reduce the load, and the condition will improve.

Tension headache in a child is treated quite simply. Parents are advised to provide the child with adequate nutrition, healthy sleep, spend more time in the fresh air, reduce the workload of the student, and allow him to rest more. Medicinal herbal teas based on chamomile, lemon balm, and mint have a calming effect.

If the cause of the deterioration is infectious processes, treatment will include antibiotics, symptomatic therapy. In case of detection of tumor formations, a consultation with a neurosurgeon is indicated.

Useful video about the causes of headaches in a child

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Headache (cephalalgia) in children is observed quite often and can serve as the main, or even the only symptom of more than 50 various diseases... Cephalalgia is any discomfort that occurs in the region from the eyebrows to the back of the head (the term is derived from the Greek words cephal- the brain and algos- pain).

It is known that 80% of European adults suffer from headache (GB). It can be assumed that the prevalence of cephalgia among children is approximately the same. Up to 7 years of age, 75% of patients have a migraine-type headache; however, the most common type of cephalalgia is tension headache.

The classification of the International Society of Headache provides for the following cephalgias: migraine; GB voltage; cluster (bundle) GB and chronic paroxysmal hemicrania; GB, not associated with structural brain damage; GB due to head trauma; GB due to vascular diseases; GB due to intracranial non-vascular diseases; GB due to the intake of certain substances or their withdrawal; GB due to extracerebral infections; GB due to metabolic disorders; head or facial pain due to pathology of the skull, neck, eyes, ears, nose, sinuses, teeth, mouth, as well as other facial or cranial structures; cranial neuralgia, pain in the pathology of the nerve trunks and deafferentation pain; unclassified GB. All these types of cephalalgia can occur in children, although in practice migraines, tension headaches and cluster (bundle) headaches are more common.

In general, in the etiopathogenesis of cephalalgia, the sources of pain can be areas of the dura mater; arteries of the base of the brain and intracranial arteries; the tissues covering the skull; nerves (among them the cranial nerves - the trigeminal, glossopharyngeal, vagus, as well as the first and second cervical spinal roots). The morpho-functional basis of the peripheral part of the system responsible for pain sensitivity is the trigeminal nerve and the nucleus of its spinal tract. Pain receptors are possessed by the dura mater and large blood vessels, as well as the sensitive endings of the fibers of the second cervical root of the spinal cord. The described systems form various types of headaches.

Headache can be caused by intracranial lesions, such as subdural and intracerebral hematomas, subarachnoid hemorrhages, thrombosis, arteriovenous malformations, brain abscess, meningitis, encephalitis, vasculitis, obstructive hydrocephalus, condition after lumbar puncture, cerebrovascular accident, cerebrovascular accident, cerebrovascular accident , damage to the dura mater of the base of the brain and sensitive cranial nerves... From extracranial causes, headache is caused by sinusitis, injuries of the cervical spine, temporomandibular joint syndrome, giant cell arteritis, glaucoma, optic neuropathy and dental diseases. There are also "common" causes of headache: fever, viremia, hypoxia, hypercapnia, arterial hypertension, allergies, anemia, as well as the action of vasodilators (nitrites, carbon monoxide, etc.).

The pathophysiological features of the three main types of headache in pediatric patients are discussed below, since it is these features that determine the different approaches to treatment.

Migraine. For classical migraine, two phases of an attack are characteristic: in the first phase, vascular spasm occurs, causing cerebral ischemia and various focal symptoms that trigger an attack; in the second phase (transcranial and extracranial vasodilation), pulsating GB begins, which is distributed in the area of innervation of the trigeminal nerve and upper cervical roots. In migraine with aura, the mechanism of HD development involves paroxysmal depolarization of neurons in the cerebral cortex. In the first phase of an attack, cortical depression spreading at a rate of 2 mm per minute is observed in the occipital pole of the brain. In the region of wave propagation, profound changes in the ion distribution occur, leading to a decrease in the level of cerebral blood flow. Cerebral ischemia is the result of constriction of arterioles. Most characteristic feature classic migraine - general hypovolemia in the back of the brain. GB is caused by the effect of spreading depression on the fibers of the trigeminal nerve on the meninges, while the vasoactive intestinal peptide, substance P and some other peptides are released. The factors that trigger the mechanism of pervasive cortical depression are numerous. Among them are any violations of potassium homeostasis, genetic predisposition, stress, nutritional factors, as well as the release of vasoactive peptides from the trigemino-vascular system.

With simple migraine (without aura), there are no significant changes in cerebral blood flow, and the mechanisms of its development are difficult to explain. In addition to vascular changes (characteristic of classic migraine), with simple migraine, metabolic disorders and the concentration of neurotransmitters (serotonin and its metabolites) are observed.

The reason for the development of migraines can be prostaglandin E1, tyramine or phenylethylamine (the last two amines are found in chocolate and cheese).

Tension headache. Previously, it was believed that this type of headache is a direct consequence of repeated contractions of the muscles of the neck and temples, leading to local ischemia of these structures. In recent years, a number of other links of pathogenesis have been considered, including the involvement of "trigger" points of some muscles (trapezius, sternocleidomastoid, suboccipital, temporal, etc.), compression of blood vessels by spasmodic muscle with venous congestion, the spread of pain to the temporal, parotid and occipital regions due to dysfunction of the temporomandibular joint, violation of the closure of the teeth of the upper and lower jaws, etc.

Cluster (beam) headache. The pathogenesis of the disease is still poorly understood and not entirely clear, although it is known that with this type of GB in the external jugular vein there is an increase in the content of some pain peptides (calcitonin of genetically linked and intestinal peptides). As a result, a neurogenic origin of cluster headache with activation of sensory fibers of the trigeminal nerve is assumed. A certain role can be played by a defect in the chemoreceptors of carotid bodies on the pain side, as well as impaired secretion of certain humoral factors (melatonin, cortisol, testosterone, β-endorphin, β-lipoprotein, prolactin).

Headache symptoms. In each case, the symptoms of headache are determined by the type of cephalalgia present. Below are the features of various types of chronic and recurrent headache for a number of indicators (nature, localization, duration of the attack, frequency, concomitant symptoms). Simple migraine: the character of GB is pulsating; localization - one- or two-sided; duration of an attack - 6-48 hours; periodicity - sporadic attacks (up to several times a month); accompanying symptoms - nausea, vomiting, malaise, photophobia. Classic migraine: the character of GB is pulsating; localization - one-sided; duration of an attack - 3-12 hours; periodicity - sporadic attacks (up to several times a month); accompanying symptoms - visual aura, nausea, vomiting, malaise, photophobia. Facial migraine: the nature of GB is dull or throbbing; localization - one-sided, in the lower half of the face; duration of an attack - 6-48 hours; periodicity - sporadic attacks; accompanying symptoms - nausea, vomiting. Cluster headache (Horton's histamine cephalalgia): the nature of GB is acute, boring; localization - one-sided (mainly in the orbit); the duration of the attack is 15-20 minutes; periodicity - periods of daily attacks alternate with long-term remissions; accompanying symptoms - on the side of pain, there may be lacrimation, facial flushing, nasal congestion and Horner's symptom. Psychogenic headache: the nature of GB is dull, constricting; localization - diffuse bilateral; the duration of the attack is often constant; the frequency is often constant; accompanying symptoms - depression, anxiety. Trigeminal neuralgia: the nature of the pain - shooting; localization - in the zone of innervation of the trigeminal nerve; the duration of the attack is short-term (15-60 seconds); periodicity - many times a day; accompanying symptoms - trigger zones are identified. Atypical facial pain: the nature of GB is dull, localization is one- or two-sided, the duration of the attack is often constant; the frequency is often constant; accompanying symptoms - depression, sometimes psychosis. Headache with sinusitis: the nature of GB - dull or acute; localization - one- or two-sided, in the area paranasal sinus; the duration of the attack - varies; periodicity - sporadic or constant; accompanying symptoms - nasal discharge.

Diagnostics. The specific diagnosis in children is established mainly on the basis of clinical signs and the aforementioned criteria of cephalgic syndromes. The so-called headache diaries, some laboratory and instrumental research(X-ray of the skull, CT scan and magnetic resonance imaging of the brain, EEG, transcranial Doppler examination of the vessels of the brain). An important diagnostic measure is an ophthalmologist's consultation, and if a patient is suspected of having depression, a child psychiatrist's consultation is required.

The diagnosis of "migraine" is usually established on the basis of the collected history, with any pronounced changes with careful physical, neurological and ophthalmological examinations cannot be identified. Most other cephalgic syndromes are diagnosed using a similar algorithm.

Approaches to headache treatment

Not all drugs used in the treatment of hypertension in adults can be used in pediatric practice due to age restrictions. A classic example is analgin (metamizole sodium), which in world practice is not prescribed to children under 14 years of age (in the Russian Federation - up to 6 years). Another drug that should be used with caution in patients under 16 years of age is the non-narcotic analgesic naproxen (nalixan).

Below we list modern approaches to the treatment of the three main cephalgic syndromes - migraine, cluster headache and tension headache.

Migraine treatment. Prophylactic treatment is carried out only with recurrent cephalgias that are resistant to the emergency therapy used. Migraine attacks should only be treated when it comes to frequent, severe attacks that interfere with the child's active life. In some cases, one has to count on only a partial effect, although the appointment of vasoconstrictors such as ergotamine and / or caffeine at the first symptoms of an attack can help to stop it (in the Russian Federation, the drug cofetamine, which combines both of these components, is widely used). It is prescribed for children over 10 years of age twice, with an interval of 30 minutes, 1 tablet per dose (each tablet contains 0.1 g of caffeine and 0.001 g of ergotamine tartrate). The appointment of simple (non-narcotic) analgesics (paracetamol, etc.) is often no less effective.

In an acute migraine attack, the regime moments should be combined with taking analgesics: resting the child in bed (in a dark room) and taking paracetamol or acetylsalicylic acid. The latter is used with caution in pediatrics (in children under 2 years of age - only for health reasons) in order to avoid the development of Reye's syndrome. It is paracetamol (at a dose of 15 mg / kg / day) that is the most effective and safe agent prescribed for migraine attacks of moderate and severe severity. Acetylsalicylic acid is effective only for mild attacks. Other medications for treatment severe attacks- naproxen, ibuprofen, phenacetin or caffeine (alone or in combination with other medicines).

For children over 10 years old, ergotamine is considered the drug of choice. It is prescribed orally at the very beginning of the attack (the dose depends on the dosage form, the duration of the course of treatment should not exceed 7 days). The drug is contraindicated in children who have hemianopsia or hemiparesis in the constrictor phase of an attack.

Phenacetin, like paracetamol, refers to non-narcotic analgesics. It is used 2-3 times a day in combination with drugs such as analgin (taking into account age), caffeine, etc. Its use is limited due to the presence of side effects ( allergic reactions, "Phenacetin" nephritis, methemoglobinemia, anemia, etc.). Phenacetin is prescribed at the rate (single dose) 0.15 g - for 3-4-year-old patients, 0.2 g - for children 5-6 years old, 0.25 g - for 7-9-year-olds and 0.25-0 , 3 g - for 10-14-year-old children (for patients under 1 year old - 0.025-0.05 g each, up to 2 years old - 0.1 g each). In the Russian Federation, phenacetin is produced mainly in tablets containing 0.25 g of phenacetin itself and acetylsalicylic acid, 0.05 g of caffeine). Phenacetin is part of combined funds(asphene, kofitil, newigrofen, pirkofen, sedalgin, citramone, etc.).

Ibuprofen (Brufen) is a non-steroidal anti-inflammatory drug (NSAID). Children are prescribed at the rate of 20-40 mg / kg / day (3-4 times a day, per os or rectally).

Naproxen is another NSAID prescribed for children under 5 years of age at the rate of 2.5-5 mg / kg / day in 1-3 doses (duration treatment course- up to 14 days), and for patients over 5 years of age - at a dose of 10 mg / kg / day.

Caffeine is a psychomotor stimulant used in combination with other medicinal substances (analgesics, etc.). Children over 2 years old (the drug is not prescribed before this age) doze caffeine at 0.03-0.075 g per dose (2-3 times a day). Caffeine is a part of combined tablets (cofetamine, askofen, novigrofen, cofficil, pyramine, citramone, etc.).

Sumatriptan (a selective 5-HT1 receptor agonist) is effective in the treatment of migraine attacks in adults. However, in the treatment of children with migraine, sumatriptan does not offer any advantages over ibuprofen.

Preventive treatment. Propranolol for children is prescribed orally at an initial dose of 0.5-1.0 mg / kg / day 2 times a day, the maintenance dose is 2-4 mg / kg / day. In the presence of heart failure or bronchospasm, the drug is not used.

Flunarizine - blocker calcium channels... Children weighing up to 40 kg are prescribed in a dose of 5 mg 1 time per day. For the rest of the categories of children, flunarizine is prescribed in the same way as for adults (20 mg 1 time in the first 2 weeks of preventive treatment, then 5-10 mg / day in 1-2 doses).

Anticonvulsants of the phenobarbital or valproic acid class in some cases prevent an attack, but are prescribed only for frequently recurring attacks. Dosages for both anticonvulsants are selected individually (under the supervision of a physician).

Tricyclic antidepressants (amitriptyline, etc.) are rarely used to prevent migraine (more often these drugs are used for tension headaches).

Symptomatic remedies. For nausea and vomiting, metoclopramide (cerucal, raglan) is used at a dose of 0.5 mg / kg (intravenous, intramuscular or oral). In this case, chlorpromazine (a neuroleptic from the group of phenothiazine derivatives) and prochlorperazine are also used.

Chlorpromazine. To achieve a quick effect, you can use up to 3 age-specific doses of the drug (intravenously) every 15 minutes. At parenteral administration in children older than a year, a single dose is 250-500 mcg / kg (the maximum dose in children under 5 years of age or with a body weight of up to 23 kg reaches 49 mg / kg / day, and at the age of 5-12 years or with a body weight of 23 -46 kg - 75 mg / kg / day). When taken orally to patients aged 1-5 years, the drug is prescribed in a daily dose of 500 mcg / kg (every 4-6 hours), for children over 5 years old - from 1/3 to 1/2 of the adult dose (a single dose for adults is 10- 100 mg, daily - 25-600 mg). Maximum dose for children under 5 years old when taken orally - 40 mg per day, for patients over 5 years old - 75 mg per day.

Non-drug treatments for migraines

Diet therapy. Insofar as food allergy often plays the role of a triggering factor for migraines in children, it is recommended to exclude a number of products from the diet of a child suffering from migraines (milk, cheese, eggs, chocolate, oranges, wheat and rye flour, tomatoes, etc.). Foods with food additives such as monosodium glutamate and nitrites should be avoided.

Other non-drug approaches to the preventive treatment of migraines include wushu, karate, yoga, the training system "biological feedback", Acupuncture.

Cluster headache treatment. Sumatriptan is widely used in the treatment of acute attacks of the disease. NSAIDs and ergotamine derivatives are considered less effective drugs. Inhalation pure oxygen also included in the number of therapeutic measures for the development of cluster headache attacks (inhalation of 100% oxygen).

Preventive treatment of cluster headache involves the appointment of β-blockers (propranolol, etc.), carbamazepine, lithium preparations, as well as prednisolone (with a course of no more than 5 days) and calcium channel blockers (verapamil). The dosage for propranolol is given above.

Carbamazepine (tegretol, finlepsin) is an anticonvulsant (iminostilbene derivative). Average daily dose the drug (inside) is 20 mg / kg / day (on average in children under one year old - 0.1-0.2 g, 1-5 years old - 0.2-0.4 g, 5-10 years old - 0.4 -0.6 g, 10-15 years old - 0.6-1.0 g / day).

Of the lithium preparations, lithium carbonate (contemnol, sedalite) is more commonly used. This normotimic agent is taken with meals, washed down with water or milk. At the same time, the content of lithium in the blood is monitored, maintaining its concentration of 0.5-1.0 mmol / l. At a dose of lithium carbonate of 1.0 g / day, the normalization of the lithium concentration should be expected in 10-14 days. The course of prophylactic monotherapy with lithium carbonate preparations should be at least 6 months.

Prednisolone. If necessary, in the first days of treatment, this corticosteroid hormone is prescribed (per os) at the rate of 1-1.5 mg / kg body weight / day, then the dose is reduced and the drug is canceled.

Verapamil (isoptin, phenoptin) is a calcium channel blocker. It is taken orally during or immediately after a meal (in 2-3 doses). The drug is taken with a sufficient amount of liquid. For children aged 1-15 years, the dosage is 0.1-0.3 μg / kg / day (single dose not more than 2-5 mg).

Tension headache treatment. In this disease, the leading role belongs to NSAID treatment... In addition, a combination of NSAIDs with diazepam (seduxen, relanium) can be used. The latter is prescribed (when taken orally) in the following single dosage: 1-3 years - 0.001 g, 3-7 years - 0.002 g, 7 years and more - 0.003-0.005 g.

Tizanidine (sirdalud) is a centrally acting muscle relaxant widely used in the treatment of tension hypertension in adults. Experience with its use in children is limited.

Tricyclic antidepressants (amitriptyline, imipramine). Regardless of age and route of administration (oral, intramuscular, intravenous) amitriptyline is prescribed from 0.05-0.075 g / day, gradually increasing the dose by 0.025-0.05 g until the effect is achieved. Imipramine (melipramine, imizine) is prescribed for children starting from 0.01 g once a day, gradually (within 10 days) the dose is increased to 0.02 g for children 1-7 years old, up to 0.02-0.05 g for children 8-14 years of age (for patients over 14 years old - up to 0.05 g or more per day).

Literature

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Any pain for a child is dangerous, but there is a special situation with the occurrence, which can be a sign of problems both with the brain and many other systems and tissues. A particular difficulty is the problem with its recognition, especially in young children who cannot describe their complaints in detail and accurately.

note

It is important to understand that doctors always refer to headaches as dangerous signs; in healthy children, such a symptom never develops.

How younger child, the more serious are usually the reasons for the formation of headaches, especially those that have arisen against the background of full health. They need to be immediately clarified and eliminated.

Headache in a child: does it always indicate pathology?

For the appearance of headaches from early childhood, many organic and functional reasons, and such a complaint is one of the ten most common complaints among preschoolers and schoolchildren. Of course, headaches are possible in young children, but they cannot describe them exactly, and sometimes doctors and parents have to recognize such symptoms on the basis of indirect signs.

If we talk about a child of preschool, and especially school age, then he can quite clearly and clearly describe his complaints about headaches. Can be figured out as a character pain, and localization, features of the symptom. After a short questioning, you can find out in what situation and after what events the pain arose, and if they are repetitive, than they are usually provoked. You can also check with children how their pain is relieved or completely disappears.

Attention!A special situation is adolescent headaches. They can arise due to the temporary dissonance of the growing and developing organism during puberty. But it is also important to take into account the fact that such pains can be attempts at simulation because it is a subjective symptom that is extremely difficult for parents and a doctor to evaluate.

For a better understanding of all the processes that can occur in the child's head, as well as to facilitate understanding of the causes of pain development and its origin, it is important to at least briefly disassemble certain anatomical and physiological foundations of the structure and functioning of the head. So, the brain itself does not possess pain receptors, but there are a lot of them in all the formations surrounding it. All anatomical areas of the head have pain receptors that can form pathological impulses. Areas of venous sinuses, cranial nerves and the zone of the meninges are rich in pain receptors, in addition - large vessels of the head, periosteum or soft tissue in the region of the skull. In addition, all large vessels of the neck and facial tissues are equipped with pain receptors, which can also form pain impulses with reflected signals.

The perception of pain is formed due to the stimulation of the receptors by all kinds of chemical or physical impulses, excitation is formed and a stream of impulses is transmitted through sensitive fibers to the pain centers of the brain.

If only certain areas or zones are excited, then the pain is felt in the form of a local one, but if irritation is formed from large areas on the skull or internal structures surrounding the brain, there may be a feeling of a diffuse, general headache.

Headache: definition of the concept

From a medical point of view, headache is one of the most extensive and extensive concepts. It is called the scientific term "cephalalgia", but this definition can fall within its essence any unpleasant, subjectively uncomfortable sensation in the head area. Because of this, the concept of cephalalgia includes both a feeling of heaviness and mild pain, and the sharpest, sharp and excruciating pain sensations.

According to their localization, it is customary to classify sensations that arise throughout the entire area, starting from the brow ridges and up to the border where the back of the head passes into the neck (the place where the skull is attached to the spine), are considered to be cephalgic pains.

In children, headaches are formed for various reasons, related both to themselves bone formations skull, and with its vessels or nerve endings and trunks, all meninges, its additional structures. Headaches can also form due to various disorders in the cervical spine, as well as disturbances in the work of the shoulder girdle, pathology internal organs, tissues or the whole organism.

note

It is important to emphasize that headaches are not diseases, they are just a symptom of pathologies and problems that have different causes and mechanisms of occurrence, but irritate the receptors in the head area (often also the neck) and give soreness, which is interpreted as headaches.

Variants of headaches in childhood

Not all headaches are the same in their origin and manifestations. Therefore, it is customary for experts to distinguish two groups of headaches:

If headaches are referred to as one of the leading symptoms in the clinical picture, or even the only complaints, and it is due to them that the child feels extremely bad, he has expressed ailments, then we are talking about pain ... Such pain can be typical for various processes - microbial, viral infections. In addition, these types of pain are primary, typical for, cluster or cluster pain, or tension headache.
if headaches are one of the many other extremely unpleasant symptoms, they are related to ... Then these complaints are not classified as leading in the clinic, they are regarded as a complex with all other manifestations, and they are typical for many pathological conditions and somatic diseases. Secondary headaches can be manifestations of various types of infections, febrile reactions, which will gradually disappear as the condition normalizes or the fever is eliminated.

If we talk specifically about secondary headaches, about two hundred reasons for their formation are known. Primary pains are much less, and they are usually more severe and pronounced.

Causes of children's cephalalgias

Of course, it is practically impossible to list all the possible situations in which headaches in children are possible, since this manifestation can accompany almost any somatic and infectious disease, and is also a manifestation of many traumatic, hypoxic and toxic processes. In addition, it is important to understand that several processes can provoke the development of pain at once, a combination of negative factors and problems on the part of the body, the impact of external and internal influences. But among the whole variety of processes leading to cephalalgia in childhood, the most frequent and strongly influencing causes can be distinguished.

The most common and frequently reported reasons for pain in childhood are:

Consequences after bruises, falls or bumps
Reactive reactions that arise in response to abrupt changes in environmental factors - temperature fluctuations, precipitation, or changes in the geomagnetic situation
Secondary pains of a reactive nature, formed as a result of changes in the body of children against the background of the development of allergies, prolonged sleep or constant lack of sleep, as a reaction to some medical manipulations
Reactions to infectious agents, taking certain medications, or food additives, certain types products, as a consequence of dehydration or as a response to the problematic work of certain internal organs (kidneys, liver, heart).
Pain sensations that form inflammation processes localized in the paranasal sinuses (ethmoiditis or pansinusitis)
Pain arising from an overdose, which was applied without any indications for them
Tension-related headaches, if children are severe against the background of prolonged mental stress, prolonged sitting in front of the monitor
, which differ significantly in severity and duration, as well as the type of pain sensations, or cluster headaches that rarely occur in adolescents, which today have not yet been precisely clarified.

The occurrence of any complaints of a child about headaches, even minimal and not acute, localized in the temples, frontal zone or the back of the head, should be a reason for consulting a doctor, especially if there are no signs of a cold, somatic infections, and headaches are repeated repeatedly.

Features of cephalgia depending on age

Headaches are possible in any age group of children, including newborns, but it is in the latter that these symptoms are most difficult to diagnose. This is due to a complex of nonspecific behavioral reactions in response to pain impulses and the inability to verbally express their feelings. It is often very difficult for the doctor and parents to determine the exact localization of pain sensations and their strength. There are certain age-specific features in the development of cephalgia, and the most associated typical reasons sensations:

In addition to age and the reasons for the development of pathology, it is also necessary to take into account the localization of painful sensations - the frontal region, temporal or occipital, as well as the time of onset, duration of sensations and their accompanying manifestations.

A variety of factors can play a role in the development of headaches in childhood, which include, in addition to all previously listed:

Various forms of headaches have their own specificity in the clinical picture and accompanying manifestations, as well as the peculiarities of the course, depending on age boundaries, due to which it is worth making out the most frequent types in details.

Tension headaches: what is special in children

This type of headache is functional, and one of the most common in childhood. This type of pain and discomfort occurs as a result negative influences on children, both acute stress factors and chronic, constantly influencing from day to day. Depending on age, stress factors can be attributed to various influences - too strong physical activity, disproportionate to age, overwork from noisy games and an abundance of guests, if it is a child of an early age, violent emotions and experiences (both negative and positive).

The mechanism of such pain, especially stress-related pain, is relatively simple. A process of active and pronounced contraction of muscle elements in the head area is formed. This is especially true for the vessels, which also contract. Located in the head area and cervical area vessels that, due to muscle contraction, come into a state of spasm, form irritation of pain receptors, as a result give a feeling of headache.

On average, the duration of such pains can range from a couple of hours to several days or even a week, it all depends on which of the factors affect the receptors. These pains are described as a sensation of tightness or tightness of the head in a hoop, a sensation of sharp pressure in the neck, temples or occiput. At the same time, sensations can be formed inside the head, which are similar to the state of "wearing a helmet or helmet." The intensity of pain is not very high, in view of which the child retains working capacity and can perform daily activities, working capacity and psyche do not suffer, but the learning process and concentration of attention, behavior may suffer.

What is special about these headaches?

With them, painful sensations can increase with physical exertion or emotional experiences, and at the peak of the attack, nausea occurs with refusal to eat, intolerance to light and sounds, and increased pain from strong stimuli of the sensory organs.

In some cases, a similar headache can be triggered by a child being in a static position for a long time, especially during school hours. This may be due to the wrong choice of furniture for school and homework. The same kind of pain may occur with visual problems, due to the tension of the visual analyzer.

Vascular pain: features in children

In order for the child's brain, which consumes the largest amount of oxygen from all body tissues, to work actively and fully, it needs an uninterrupted supply of oxygen and nutrients through the cerebral vessels. By virtue of various pathologies, dysregulation vascular tone, prolonged stress or other factors, the vessels of the brain spasm, or excessively stretch. As a result, blood either flows poorly to the brain, or flows out of it with difficulty, which leads to a disruption in the supply of oxygen. The brain reacts sharply and sharply to such changes, which forms headaches. Such problems are typical for schoolchildren and adolescents, which in the future can result in manifestations (VVD).

Changes in intracranial pressure: features of children

A change in the pressure of the cerebrospinal fluid (this is cerebrospinal fluid circulating around the brain) is possible in normal conditions against the background of physical activity and stress, with severe cough and straining when lifting heavy objects. Such temporary episodes do not manifest themselves in any way, and the pressure quickly enough comes to normal values... But when certain physiological values are exceeded, if symptoms of malaise occur, it is necessary to consult a doctor in order to exclude serious pathologies and health problems.

The main symptoms include severe headaches in the morning with the formation of nausea and vomiting, these are the leading complaints of children. Against the background, the condition is always bad, but the deterioration occurs in the late afternoon or at night. Typical for intracranial hypertension is nausea resulting in nausea, which does not relieve the condition and does not relieve pain.

Headaches with ICP are localized in the occiput area, unpleasant sensations are formed in the orbital area, which is formed due to excessive pressure on the orbital area. Against the background of such pain, anxiety and constant crying, as well as sleep and appetite disorders, will also be typical.

There may be headaches due to low intracranial pressure - this is formed against the background of intestinal infections or injuries, but up to five years old, such headache symptoms are difficult to determine, babies cannot accurately describe their feelings. You can indirectly guess about a similar symptom by the presence of apathy and drowsiness, lethargy and weakness, as well as bouts of dizziness or even loss of consciousness. The nature of the headaches is dull and pressing, they are usually localized in the occiput.

Headache with infectious pathologies

One of the typical manifestations of many infections is headache and malaise, which occur against the background of viral, microbial, or other types of infections. Often, these symptoms are formed in combination with other manifestations of diseases - fever of varying severity, pain in the pharynx, or, chills, attacks of nausea or vomiting. Based on the data of all these symptoms, in combination with the indication of contact with people with colds, it is easier to diagnose children, as well as to identify the cause of the pain in the head.

A special option is a headache against the background of meningococcal lesions with suspicion of. It is typical for children at an early age, in the first year of life, as well as for preschoolers and schoolchildren. Fever and the formation of a severe headache are typical, followed by vomiting, which has nothing to do with nutrition and will not bring relief to children. General state children are rapidly and progressively disrupted, due to changes in intracranial pressure and tissue inflammation, children take forced poses with bringing their legs to the chest and throwing their head back. This condition is especially dangerous if points appear on the skin of the body that look like needle pricks or bruises, asterisks.

Pathology of the nervous system in childhood

Frequent sharp and acute headaches, which have no other manifestations, are poorly controlled by analgesics and their symptoms are atypical for other problems, may be a sign of volumetric formations in the cranial cavity or individual health disorders... To exclude such processes, it is necessary to carry out a computer or to assess visually anatomical formations in the region of the brain. They can give severe and excruciating headache, hemorrhages with the formation of hematomas, cystic cavities ,. They form a change in anatomy inside the skull, which threatens with a change in intracranial pressure. Typical manifestations of such problems are severe and excruciating headache with nausea and vomiting, as well as problems with the sensitivity of certain parts of the body, visual disturbances and epileptic seizures.

Pain in young children

It is impossible to accurately determine the presence of headaches in a baby at an early age, this is due to the fact that the child cannot speak and write his complaints in detail. They can indirectly indicate health problems and headaches, such as anxiety and crying, sleep disturbances, provided that the child is fed, he is dry and there is no apparent reason for irritation. If all the reasons for the child's discomfort are eliminated, but at the same time he constantly cries, screams, a neurologist's consultation is necessary. There are certain indirect signs for which you can suspect headaches in babies:

Screams and anxiety, prolonged crying intensify in the evening, intensification of screams when changing the position of the body, the transition of the crumbs from vertical to horizontal position and vice versa.
Veins on the head swell strongly, bulging and very tense
The sleep process suffers, the child falls asleep screaming or sleeps very badly both during the day and at night.
There may be sharp cries, flinching, grunting.
He can pull the handles to the head, pull his hairs
There may be frequent regurgitation of large amounts of food, vomiting
Appetite disturbance up to a complete refusal to eat
Often there is an increase in temperature, sweating
The child is pale, sleepy, lethargic.
There may be violations of muscle tone, stiffness of movements of the limbs and body with tilting the head

The causes of headaches at this age can be - the development of hydrocephalus, congenital defects of the brain and its vessels, cerebrospinal fluid spaces, intoxication and infection syndrome.

Headaches in babies from 2-3 to 5-6 years old

Children at this age can also suffer from headaches, but often they can already partially explain themselves and show the place where they have pain. But at the same time, all the symptoms will be general and relatively blurred, especially in the younger age group. Typical will be:

Irritability and whims of the child, constant crying for any reason
Attempts to put the head on the hands or knees of an adult, rubbing the head, tugging at the hair
Pallor and lethargy of the baby, refusal of noisy games and favorite activities, desire to lie down
Sleep and appetite disorders
Attacks of nausea with vomiting, sweating, and dizziness
The child points to the head and complains of pain, but cannot pinpoint the location or character.

The causes of pain at this age are usually infections, somatic pathologies, toxicosis, the consequences of head injuries and falls, tension pain associated with excessive emotional or physical stress, as well as pathologies of the nervous system.

Headaches in children over 6 years old

In children after 6 years of age, the characteristics of headaches are approximately comparable to those of adults, the child can already accurately and adequately assess the localization, strength and nature of the pain. At this age, the headache can be acute or chronic, paroxysmal or persistent. It can be a sign of various kinds of pathologies. Most often it can be infections and somatic pathologies, vascular pain as a manifestation of vegetative-vascular dystonia (VVD), as well as migraine or pain as a result of tension.

Less often, pain occurs as a result of inflammatory, tumor or traumatic lesions of the nervous system itself, which requires urgent consultation with a neurologist. There may be variants of psychogenic headaches during adolescence, which can be prolonged and persistent. They are provoked by family problems, stress, conflicts with peers.

What to do if a child has a headache?

Naturally, elimination of the cause of pain and treatment of the underlying disease in most cases leads to the elimination of an unpleasant symptom. But while the reasons are being clarified, or in the presence of extremely unpleasant symptoms of pain, you can help in alleviating the baby's condition. To reduce the intensity or completely eliminate the attack, the following are applicable:

Usually, such methods are quite enough to eliminate headaches, they disappear within a couple of hours. If the pain does not subside, but only intensifies, you should consult a doctor or call an ambulance. The reason for the ambulance will be severe excruciating and intolerable pain, vomiting and dizziness, inappropriate behavior of the child.

It is important to have a mandatory examination of a baby at any age in the presence of:

Constant and severe pain, the intensity of which is high and does not decrease with the usual pain relievers.
episodes of pain occur more than once a month.
have symptoms such as nausea or vomiting, mental problems, visual disturbances, problems with coordination or sensitivity.
a rash appeared on the skin, high fever, convulsions, various neurological symptoms and head tilting, convulsions. You need to call an ambulance immediately.

Diagnostics and treatment of cephalalgias in children

In each case, the diagnostic tactics and treatment measures will depend on the causes that provoke the pain. To do this, you need to contact a pediatrician or neurologist who will examine the baby, study all the complaints of himself and his parents, as well as data from life and medical history that can help in recognizing the causes of the pathology.

A whole series of laboratory tests, as well as radiography and contrast studies of blood vessels, CT or MRI of the head and neck, can be prescribed to find out the true causes. Also, vessels, or ultrasound of the brain (if these are young children), as well as all kinds of additional research, which will be necessary for the doctor to establish an accurate diagnosis.

Treatment is prescribed based on the cause that caused the attacks of cephalalgia.... If these are episodic pains of tension, or attacks caused by overloads, some influences, you can do without medication - you need to change the daily regimen, reduce stress and proper rest, sleep of the child, his long stay in the fresh air. Sedative and soothing teas and decoctions, infusions, rationalization of work and rest, rejection of prolonged static loads, TV and computer can help.

Alena Paretskaya, pediatrician, medical columnist