Cefalea en pediatría: tumor embrionario. Reporte de caso

Background: headache accounts for 0.7 to 6% of the reasons for consultation in the pediatric emergency department. The pediatrician's challenge is to rule out or identify those headaches with secondary etiologies.

Case report: seven-year-old patient admitted with holocranial headache of fifteen days of evolution, who in the last days presented left hemicranial lateralization with increased frequency and intensity of pain, which sometimes woke him up during sleep. Physical examination revealed right papilledema, with no other alterations. Magnetic resonance imaging showed an embryonal tumor of the central nervous system with a large fusiform pattern with compressive effect and deviation of the midline. It required neurosurgical management, chemotherapy and radiotherapy.

Conclusions: the approach to headache is critical. The anamnesis should be structured and, subsequently, the entity should be classified. Physical examination includes vital signs, examination by systems and neurological assessment with emphasis on fundoscopy. The diagnostic approach to headache is based on structured anamnesis to rule out secondary causes. The physical examination should be thorough and focused on ruling out neurological symptoms. In this case, nocturnal awakening by pain and identification of papilledema were key.