Pediatric emergency medicine trisk 1140 1140
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TABLE 59.3
LIFE-THREATENING CAUSES OF HEADACHE
Vascular
Hypertension
Hypoxia
Coarctation of the aorta
Stroke
Inflammatory
Meningitis
Encephalitis
Ventricular shunt infection
Traction/compression
Brain tumor
Intracranial hemorrhage
Hydrocephalus
Cerebral edema
Brain abscess
Arterial dissection
Ventricular shunt failure
Environmental
Carbon monoxide poisoning
Finally, hypoxia is a potent stimulus for cerebral vasodilation and can produce
headaches on that basis. Therefore, children who experience a hypoxic insult
(e.g., carbon monoxide poisoning) or those with disease states that predispose to
hypoxia (e.g., cystic fibrosis, cyanotic heart disease) may present with headaches
resulting from an acute process or an exacerbation of an underlying illness.
Muscle Contraction
Headaches can be caused by contraction of the scalp or neck muscles. This is the
classic “tension” headache that is common in adults. These headaches usually
occur when a patient has experienced prolonged mental or emotional stress or
desk work with inadequate attention to ergonomic factors. This leads to recurrent
episodes of muscle tension and/or spasm, which cause muscle soreness. The
patient can often localize a specific site where the pain is felt, and the involved
