ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ

خرید پکیج

تعداد آیتم قابل مشاهده باقیمانده : 3 مورد

Important aspects of the examination of a child with headache

Important aspects of the examination of a child with headache

Examination feature	Possible significance
General appearance	Altered mental status may indicate meningitis, encephalitis, intracranial hemorrhage, elevated intracranial pressure, hypertensive encephalopathy.
Vital signs	Hypertension may cause headache or be a response to increased intracranial pressure Fever suggests infection (most commonly upper respiratory infection) but may occur with intracranial hemorrhage or central nervous system malignancy
Head circumference	Macrocephaly may indicate slowly progressive increases in intracranial pressure.
Height and weight trajectories	Abnormal or altered trajectories may indicate intracranial pathology.
Auscultation of the neck, eyes, and head for bruit	Bruit may indicate arteriovenous malformation.
Palpation of the head and neck	Localized scalp tenderness may occur in migraine and tension-type headaches Scalp swelling may indicate head trauma Sinus tenderness may indicate sinusitis Temporomandibular joint (TMJ) and/or masseter tenderness suggests TMJ dysfunction Nuchal rigidity may indicate meningitis Posterior neck pain may indicate an anatomic abnormality (eg, Chiari malformation) Thyromegaly may indicate thyroid dysfunction
Visual fields	Visual field abnormalities may indicate increased intracranial pressure and/or a space-occupying lesion.
Funduscopy	Papilledema may indicate increased intracranial pressure Funduscopic examination is normal in primary headache
Otoscopy	May demonstrate otitis media; hemotympanum may indicate trauma.
Oropharynx	Signs of pharyngitis? Dental decay or abscess?
Neurologic examination (see text for details)	Abnormal neurologic examination (particularly mental status, eye movements, papilledema, asymmetry, coordination disturbance, abnormal deep tendon reflexes) may indicate intracranial pathology but also may occur with migraine headache.
Skin examination	Signs of neurocutaneous disorders (eg, neurofibromatosis, tuberous sclerosis complex, which are associated with intracranial neoplasms) or trauma (bruises, abrasions, etc).
Spine	Signs of occult spinal dysraphism (eg, midline vascular of pigment changes), which may be associated with structural abnormalities (eg, Chiari malformation).

Data from:

Great Ormond Street Hospital for Children Clinical Guideline. Headache. www.gosh.nhs.uk/clinical_information/clinical_guidelines/cmg_guideline_00045. Accessed on March 29, 2011.
Lewis DW, Koch T. Headache evaluation in children and adolescents: When to worry? When to scan? Pediatr Ann 2010; 39:399.
Newton RW. Childhood headache. Arch Dis Child Educ Pract Ed 2008; 93:105.

Graphic 59967 Version 8.0

آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟