Orthostatic Headache in Children Including Postural Tachycardia Syndrome and Orthostatic Hypotension: A Near-Infrared Spectroscopy Study.
active standing test
adolescent
cerebral blood flow fluctuation
cerebrospinal fluid leak
children
head and/or neck pain
head up-tilt
headache
migraine
orthostatic dysregulation
orthostatic headache
orthostatic intolerance
pediatric
postural tachycardia syndrome
the International Classification of Headache Disorders 3rd edition
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
21 Dec 2020
21 Dec 2020
Historique:
received:
30
11
2020
revised:
15
12
2020
accepted:
21
12
2020
entrez:
29
12
2020
pubmed:
30
12
2020
medline:
30
12
2020
Statut:
epublish
Résumé
Although head and/or neck pain attributed to orthostatic hypotension is included in international guidelines, its mechanisms and relevance remain unknown. This study examined the term's relevance and aimed to elucidate the associated clinical features. An active stand test was performed to evaluate fluctuations in systemic and cerebral circulation in children and adolescents reporting complaints in the absence of a confirmed organic disorder. The subjects were categorized based on orthostatic headache presence/absence, and their characteristics and test results were compared. Postural tachycardia syndrome was observed in 50.0% of children with, and 55.1% without, orthostatic headache. For orthostatic hypotension, the respective values were 31.3% and 30.6%. A history of migraine was more prevalent in children with orthostatic headaches (64.1% vs. 28.6%; Fluctuations in cerebral blood flow were associated with orthostatic headaches in children, suggesting that the headaches are due to impaired intracranial homeostasis. As orthostatic headache can have multiple causes, the term "head and/or neck pain attributed to orthostatic (postural) hypotension" should be replaced with a more inclusive term.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
Although head and/or neck pain attributed to orthostatic hypotension is included in international guidelines, its mechanisms and relevance remain unknown. This study examined the term's relevance and aimed to elucidate the associated clinical features.
METHODS
METHODS
An active stand test was performed to evaluate fluctuations in systemic and cerebral circulation in children and adolescents reporting complaints in the absence of a confirmed organic disorder. The subjects were categorized based on orthostatic headache presence/absence, and their characteristics and test results were compared.
RESULTS
RESULTS
Postural tachycardia syndrome was observed in 50.0% of children with, and 55.1% without, orthostatic headache. For orthostatic hypotension, the respective values were 31.3% and 30.6%. A history of migraine was more prevalent in children with orthostatic headaches (64.1% vs. 28.6%;
CONCLUSION
CONCLUSIONS
Fluctuations in cerebral blood flow were associated with orthostatic headaches in children, suggesting that the headaches are due to impaired intracranial homeostasis. As orthostatic headache can have multiple causes, the term "head and/or neck pain attributed to orthostatic (postural) hypotension" should be replaced with a more inclusive term.
Identifiants
pubmed: 33371330
pii: jcm9124125
doi: 10.3390/jcm9124125
pmc: PMC7767397
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Japan Agency for Medical Research and Development
ID : JP19dk0310099
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