Table 1.

Summary of the evolution of the temporal pattern of headache in children (M = migraine, TTH = tension-type headache; CH = cluster headache)

Authors (year)	Type of study	Ages	Headache type	Headache evolution	Other symptoms, findings
Guidetti et al. [15]	prospective, 8-year follow-up	age 12–26 yrs., (mean age 17.9 yrs.)	M, TTH	- 26.5% of the patients with M changed to TTH.	- high rate of headache remission in males.
				- 8.3% with TTH changed to M.
				- 45% showed improvement, 34% were headache free, 15% unchanged, 6% worsened.
Hernandez-Latorre et al. [38]	10-year prospective longitudinal study	>6 ≥ 10 yrs.	M	- favorable evolution among children with headache started after 6 yrs.
				- 88% favorable clinical course; 12% placed on prophylactic treatment.
Brna et al. [39]	prospective, 20-year follow-up	mean age 11.1 yrs.	M, TTH	- 66% improvement	- triggers of headache: stress, sleep deprivation, bright light, certain foods.
				- more TTH remission	- 38% motion sickness
				- 45% with mild headaches were headache free at 20 years;	- 13% rushes sensory disturbance
				- 18% with moderate/severe headaches were headache free at 20 yrs	- 7% Alice in Wonderland syndrome
				- 72% with moderate/severe headaches continued to have moderate or severe headaches at 20 yrs.
Balottin et al. [40]	prospective, 4.2-year follow-up	< 6 yrs.	M, TTH	- headache persistence in the minority of cases associated with detection of somatic and psychiatric disorders.	-
Kienbacher et al. [12]	prospective	17.6 ± 3.1 yrs.	M, TTH	- 25.7% were headache free, 48.6% still M and 25.7% still TTH at the follow-up.	- unfavorable outcome: longer time between headache onset and first consultation
					- good prognosis: changing headache location at baseline and long clinical follow-up
Kelman et al. [42]	cross- sectional study, retrospective analysis	mean age 37.7 ± 11.7 yrs	M	- new headache triggers: hormones, alcohol, smoking, neck pain;	- stress as a trigger, photophobia, phonophobia and dizziness, decrease with age;
				- shift in headache location toward the neck.	- decrease in the strength of attacks, and reduced need to sleep or rest during headache
				- increase in rhinorrhea and lacrimation
Virtanen et al. [43]	prospective, controlled study	6-13 yrs	M, TTH	- 1/2 of M unchanged at 6 yrs; 32% changed to TTH.	- osmophobia, dizziness and balance disturbances became more typical with age
				- TTH unchanged in 35%; 38% changed to M.	- restlessness, flushing and abdominal symptoms became less marked.
				- at preschool age the location of headache was bilateral and
				- supraorbital; at puberty bilateral and temporal.
Gaßmann et al. [44]	prospective, 4-year longitudinal study	8-15 yrs	M, TTH	- M more frequent in girls than boys, and this difference increased significantly with age.
				- TTH dropped from 57% among 8-year-olds to 45.6% among 15-year-olds.
				- M increased with age from 10 to 17.1%.
Slater et al. [45]	prospective, retrospective	mean age 11.7 ± 3.6	M	- early onset of headache in boys	- higher levels of disability as shown by PedMIDAS and no. of missed schooldays in girls.
				- boys’ headache: squeezing at the top of the head; sharp pain at the back of the head	- older children were more disabled.
				- girls reported frontal and temporal headache, and pain in the back of the head; pain: throbbing, pressure, constant and sharp.
				- girls experienced more frequent and longer mean duration of headaches.
				- older children reported greater headache frequency.
Ozge et al. [46]	prospective, longitudinal, school-based six-year interval analysis	8-18 5562 children of whom 1155 followed up as adolescents	M, TTH	- childhood headache persists in adolescence, although the diagnoses mostly (71.3%) changed over time.	- PedMIDAS score higher in subjects with parents with headache history
				- M prevalence increased from 10.4% in childhood to 18.6% to adolescence in the same study sample after a 6-year interval.	- No supportive correlation with BMI MOH frequency 13.0% with migraine and high PedMIDAS score predominance
				- Headache prevalence increased with advancing age, especially in females; stress factors were the most important determinants.
				- M negatively affects daily living activities in adolescents.
Wöber- Bingol et al. [47]	cross- sectional study, retrospective analysis	3- 69 yrs	M with or without aura	- decrease in headache prevalence from childhood to adulthood in males	- aggravation by physical activity found to be decreased with age.
				- increasing of headache duration with age, prevalence of unilateral and pulsating pain, photo and phonophobia in girls.	- aura more frequent among ages 15–40 years
					- no gender differences in aura symptoms.
Maytal et al. [10]	retrospective	18 yrs or younger	CH	- clinical features of CH in childhood similar to those in adults.	-changes in associated symptoms over the years in a small number of patients
				- increase in frequency and duration of cluster periods with age in 40%.
				- decrease in duration of cluster periods in 6%
				- short cluster periods in 23% of patients in childhood and in 6% of patients in adulthood.
				- CH shifted sides in one patient.
Lampl [31]	epidemiological + 1 case report	7 years	CH	- no data about evolution of headache	- no differences between childhood and adolescent CH with regard to type of pain, associated symptoms and predominance in males.
				- frequency and duration may increase or remain unchanged over time if pts are untreated
				- although brief remissions may occur, spontaneous resolution of CH is rare.
Antonaci et al., [48]	case report and literature review	case of an 11-year-old boy	CH	- first bout 8 months; second bout 2 months, with the same pain characteristics.
				- this patient as a ‘variant’clinical picture
Arruda et al. [49]	prospective case report	9, 12 and 13 yrs	CH	- no differences between childhood and adult CH regarding frequency and duration
				- good response to indomethacin in two cases;
				- sustained long-term medical and/or spontaneous remission occurred in two patients.