Abstract
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. Another factor that seems to be involved in both obesity and headaches is the adiponectin level. Recent data also suggest new potential risk factors for atherosclerosis and platelet aggregation such as brain-derived neurotrophic factor (BDNF), sCD40L (soluble CD40 ligand), serpin E1/PAI I (endothelial plasminogen activator inhibitor), and vascular endothelial growth factor (VEGF). However, their role is controversial because the results of clinical studies are often inconsistent. This review presents the current knowledge on the potential markers of atherosclerosis and platelet aggregation, which may be associated with primary headaches.
Highlights
Headache is one of the most frequent complaints in primary care practices and a very common condition reported by children, adolescents, and young adults [1,2,3,4]
The following keywords and MeSH terms were used in different combinations: “primary headaches”, or “idiopathic headache”, or “headache disorders”, or “tension headache”, or “migraine disorders”, and “child”, or “pediatrics”, or “children”, and “obesity”, or “body mass index”, or “Body Mass Index (BMI)”, or “dyslipoproteinemia”, or “atherosclerosis”, or “vascular changes”, or “platelet aggregation”, or “brain-derived neurotrophic factor”, or “BDNF”, or “soluble CD40 ligand”, or “sCD40L”, or “endothelial plasminogen activator inhibitor”, or “serpin E1/PAI-1”, or “vascular endothelial growth factor”, or “VEGF”, or “adiponectin”
The available data support the relationship between obesity and headaches in children and adolescents [17,18,19,20,31,32,33,34,35,36,37,38,39,40,41,42]
Summary
Headache is one of the most frequent complaints in primary care practices and a very common condition reported by children, adolescents, and young adults [1,2,3,4]. The incidence of headaches increases with age. Conicella et al observed headaches in 66% of school-age children [5]. The authors demonstrated that 93% of the analyzed children presented a recent onset of headache, whereas medium- and late-onset headaches were reported by 3% and 4% of all patients, respectively [5]. The overall headache prevalence has been reported to be as high as 56% in children under 10 years of age and 91% in early adulthood [3,6]. A relationship between gender and the frequency of headaches was observed in pediatric patients. Abu-Arafeh et al described odds ratio (OR) equal to 1.53 and 1.67 for the prevalence of headache and migraine in female and male patients, respectively [3,6]. Headaches are more common in girls, whereas in prepuberty, the frequency of headaches
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