Clinical profile and etiology of headache in children presenting to a tertiary care hospital.

Abstract

Objective: To determine the clinical profile and etiology of primary headache and secondary headache in children. Study Design: Cross-sectional study. Setting: Department of Pediatrics, National Institute of Child Health, Karachi, Pakistan. Period: July 2024 to December 2024. Methods: A total of 179 children aged 5–15 years presenting with headache were analyzed after enrollment through non-probability consecutive sampling approach. Headache was categorized as primary or secondary according to “International Classification of Headache Disorders, 3rd Edition (ICHD-3)” criteria. Data were analyzed using SPSS version 26, applying appropriate statistical tests with p<0.05 taken significant. Results: Among 179 children, 96 (53.6%) were male and 83 (46.4%) female, with median age 10.2 years, (IQR 8.0–13.0). Headache duration was <3 months in 63 (35.2%) children. Primary headache was observed in 143 (79.9%) and secondary in 36 (20.1%). In children with primary headache, migraine occurred in 91 (50.8%), and tension-type headache in 52 (29.1%) children. In children with secondary headache (n=36), common causes were upper respiratory tract infection 12 (6.7%), sinusitis 8 (4.5%), meningitis 6 (3.4%), intracranial lesions 5 (2.8%), and trauma 5 (2.8%). Primary headache was linked with older age (p=0.012), urban residence (p=0.012), longer duration (p<0.001), and family history (p=0.017). Conclusion: Primary headache was the predominant type among children and was associated with older age, urban residence, positive family history, and longer symptom duration. Secondary headaches were more frequent in younger and underweight children and were mainly attributed to infectious or structural causes.