Cefaleas primarias en niños con hidrocefalia portadores de una válvula de derivación ventriculoperitoneal

Abstract

Headache, which is the clinical manifestation of intracranial hypertension, is also a clinical ailment in medical practice, as well as one of the main causes of visits in the paediatric age. Determining whether this symptom is secondary or not to a decompensation of the intracranial pressure in children with hydrocephalus is sometimes a challenging task. The aim of this study is to classify the headaches in a population of children with a ventriculoperitoneal bypass valve due to hydrocephalus. We conducted a study of a series of cases with a longitudinal follow-up. 20 children with a ventriculoperitoneal bypass valve owing to hydrocephalus were followed up over a mean period of eight months because they suffered from recurring headaches. All of them answered a questionnaire in order to define the characteristics of their headache. Those who were suspected of suffering from intracranial hypertension were submitted to a cerebral tomography study. In all, we studied 20 patients (eight males and 12 females) with a mean age of 8.6 +/- 2.8 years. Hydrocephalus was secondary to abnormalities in the craniocervical transition and myelomeningocele in all cases. The aetiology of the headache was primary migraine-type headache (14 patients; 70%), and tension-type headache (two patients; 10%). Secondary headaches appeared in four patients (20%) due to acute sinusitis, refraction errors and systemic infection; only one patient had headache due to intracranial hypertension. Migraine predominates as the primary headache in children with bypass valves--a phenomenon that can be explained by its high prevalence in the paediatric population.