Headaches in Pediatric Patients During the Past Decade: Comparative Analysis by Age Group from a Multicenter Study in Korea

Background: Headache is a common complaint during childhood and adolescence. It is important to be aware of the characteristics of pediatric headaches in order to make a precise and timely diagnosis. This study investigated the clinical characteristics of pediatric headaches according to the underlying etiology and age group.

Methods: We retrospectively reviewed the medical records of 3374 pediatric patients (2667 with primary headache [PH] and 707 with secondary headache [SH]) who presented with headaches at two centers between January 2012 and November 2023.

Results: The incidence of PH was significantly higher in adolescents (40.1% vs. 22.9%), whereas that of SH was considerably higher in preschoolers (37.5% vs. 16.3%) ( < 0.001). The prevalence of headaches attributed to infection was significantly higher in preschool and school-aged children (90.8% vs. 80.2%, < 0.001); adolescents exhibited significantly higher frequencies of cranial and cervical vascular disorders (3.7% vs. 1.3%, = 0.044) and psychiatric disorders (5.6% vs. 0.6%, < 0.001). Statistically significant differences were observed between preschool/school-aged children and adolescents in terms of headache characteristics and the prevalence of headache-associated symptoms (60.4% vs. 74.1%, < 0.001 in PH), neurologic abnormalities (10.2% vs. 23.6%, < 0.001 in PH; 2.4% vs. 11.7%, < 0.001 in SH), and headache triggers (19.9% vs. 24.2%, = 0.008 in PH; 2.0% vs. 8.0%, < 0.001 in SH).

Conclusions: Recognizing the etiology and age-specific differences in the clinical characteristics of headaches is crucial for an accurate and timely diagnosis. Tailoring the diagnostic approach accordingly helps to achieve optimal outcomes in pediatric patients with headaches.