Recurrent headache as a post-COVID-19 sequela: A case report

@#Post-COVID condition is the presence of new, recurring, or ongoing signs and symptoms for greater than four weeks after a SARS-CoV-2 infection. Persistent headache as a neurologic sequalae of COVID-19 infection is a common prolonged symptom with limited characterization in the literature. This was a case of a 27-year-old female diagnosed with mild COVID-19 who presented with fever, colds, fatigue, headache, decreased hearing, sore throat, dry cough, pleuritic chest pain, anosmia, ageusia, myalgia, and severe low back pain. Headache was described as remitting, frontally located, squeezing and moderate to severe in pain intensity. She was admitted in a tertiary COVID referral hospital for 8 days and was managed supportively. On the 10th day of illness, symptoms had resolved except for an on and off headache. The residual recurrent headache lasted for more than 5 months after being tested negative for SARSCOV2 on repeat reverse transcriptase-polymerase chain reaction (RT-PCR). The possible pathophysiologic mechanisms for neurologic manifestations and prolonged headache were hypoxia, endothelial damage through angiotensin converting enzyme receptor, and cytokine reactions. The characteristics of the symptoms remained unclear despite the proposed mechanisms for prolonged headache among COVID-19 patients.

Recurrent headache in indian adolescents.

Objective. To analyze the epidemiology and characteristics of primary recurrent headaches in Indian adolescents. Methods. This cross sectional study was conducted in three urban public schools. Adolescents of 9th to 12th grades were included and they were given a questionnaire in their classrooms in the presence of at least one of the authors, who assisted them in filling it. They were asked to provide responses based on most severe recurrent headache they had experienced rather than the more frequent one. Diagnosis was based upon the information contained in questionnaire, however, where it was inadequate, those subjects were approached telephonically. Statistical analysis was done with the help of SPSS v. 11.0. Descriptive analysis, Chi-Square test, Fisher’s Exact test, and independent sample‘t’ test were run. Results. We studied 2235 adolescents (boys: girls 1.6:1). 57.5% adolescents reported recurrent headaches in past one year. Migraine was the most prevalent (17.2%) headache followed by unspecified (14.9%) and tension type headache (11%). Family history of headache was more common in adolescents with headache (p < 0.001) compared to those without headache. Average age of headache onset was 11.33 yr (10.72 yr in girls vs. 11.75 years in boys; p < 0.001). 37.1% adolescents complained of progression of headache since its onset. A significantly higher proportion of girls suffered headache (p=0.018), particularly migraine, than boys. However, other characteristics of headache were not dependent upon gender. Headache was more prevalent in higher grades. Conclusion. Primary recurrent headaches are prevalent in Indian adolescents and migraine is comparatively the most prevalent type of headache. Female gender and increasing age is associated with higher chances to have headache, particularly migraine. It progresses in approximately one third of sufferers and aura increases the chances of worsening of headache.

Prevalence and Epidemiologic Charicteristics of Chronic Recurrent Headache in Primary School Children

PURPOSE: The purpose of the study was to determine the prevalence of chronic recurrent headache and the factors associated with it among primary school children. METHODS: The survey was performed by a special questionnaire on one thousand and eleven children in grades 4 to 6 at primary schools from 1 to 30 June 1999 in Gwangju city. RESULTS: Prevalence of chronic recurrent headaches was 17.5%(17.1% among males, 18% among girls). Over forty two point seven percent(42.7%) of the children had headache 4-6 times a month. Age at onset of headache was more predominant at 7-10 years of age. Headache most frequently occured before school(30.7%), during school(29%), and before awaking in the morning(16.5%). The highest incidence rate of chronic recurrent headache was observed on Monday(23.5%), and the lowest on Saturday(5.3%). Risk factors of chronic recurrent headaches were stress(26.1%), fatigue, poor sleep(25.1%), weather change(18.3%) and anxiety(18.2%). Of 177 cases with chronic recurrent headaches, 62 cases(35%) had family history. Among them, 50.0% of the patients had history in their mothers, 24.2% in the fathers, 17.7% in the brothers and sisters. Of 177 cases with chronic recurrent headaches, 122 cases(69%) were treated at the pharmacy(35%), hospital(23%), and herb medicine(11%). CONCLUSION: This study finds a high overall prevalence(17.5%) of chronic recurrent headache on primary school children. And among many causative factors, stress schools is most common. In conclusion, while evaluating chronic headache in children, environmental and emotional factors associated with school should be considered as well as organic causes.

A Study of The Relationship Between Headache and Depressive Trends in Elementary School Children / 대한소아신경학회지

PURPOSE: The purpose of our study is to determine the relationship between the level of depression and characteristics of headache in elementary school children. METHODS: A self-administered questionnaire was completed by one thousand and eleven children (510 boys and 501 girls) of grades 4 to 6 in Gwangju city during the period from June 1 to June 30 1999. The relationship between headaches and depressive trends was investigated with the Kovasc & Beck Children's Depression Inventory modified for Korean. Result : The prevalence of headache was 17.5% (17.1% among males, 18% among girls). The mean depressive scores in the headache group was higher than those in control group, but the difference was not statistically significant. The depression scores did not differ significantly depending on sex, and family history of headache. The depression scores did not correlate with the onset, location, severity, frequency, duration, and onset pattern of headache. The mean scores of depression in the dull and tightness pattern (17.46+/-7.18) were significantly higher than those of pulsatile and other patterns. The mean scores of depression in the onset time of occurrence of headache were significantly high before school (24.33+/-5.69), at school (15.66+/-6.32, P<0.05). The mean score of depression in the aura was significantly high "inaudible (22.00+/-9.49)" and in the trigger factors was significantly high weather change (16.18+/-6.85, P<0.05). CONCLUSION: Based on our analysis, there is a correlation between depressive trends and characteristics of headache in elementary school children. So, we suggested that depressive trends should be evaluated in children with headache.