Clinical course and diagnosis of migraine headaches in hydrocephalic children

Pediatr Neurosurg. 1991-1992;17(6):310-6; discussion 316. doi: 10.1159/000120616.

Abstract

Headaches, vomiting and altered sensorium can be seen in patients with migraines as well as in patients with shunt malfunctions. This is a report of 10 patients with hydrocephalus and CSF shunts who presented with headache, vomiting, varying degrees of impairment of consciousness, and coma. Various diagnostic considerations were made: shunt malfunction, slit ventricle syndrome and low pressure (overshunting). Repeated operative procedures were performed in all. 7 of 10 patients had a family history of migraines when the diagnosis of migraine was entertained, 8 patients improved on propranolol therapy, 1 failed with this therapy but responded to verapamil. In the remaining 2 patients, after a transient response to propranolol, compartmentalized hydrocephalus became obvious and improvement followed with shunt procedures. It is concluded that in those patients with hydrocephalus and small ventricles on neuroimaging and a family history of migraines, and in the face of documented adequate shunt function, the diagnosis of migraines be entertained before further operative interventions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cerebrospinal Fluid Shunts / instrumentation*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrocephalus / surgery*
  • Infant
  • Infant, Newborn
  • Male
  • Migraine Disorders / etiology*
  • Migraine Disorders / surgery
  • Postoperative Complications / etiology*
  • Postoperative Complications / surgery
  • Reoperation
  • Ventriculoperitoneal Shunt / instrumentation