Objective: To assess the etiology of occipital headaches among children visiting the emergency department (ED).
Background: Occipital headache is considered by some authors a risk factor that requires further analysis.
Methods: Subjects were children aged 5-18 years who were referred to the ED due to headaches during the years 2013-2014.
Results: During the study period, 314 patients with headaches were seen at our ED (1.7%). Thirty-nine patients had occipital headaches. Of the 314 patients, 78 underwent imaging at hospitalization or after discharge. Among the occipital group, 13 (33%) patients underwent imaging. With respect to etiology; patients with occipital headaches were 3 times more likely to experience trauma. Among the whole sample, viral infections were the most prevalent final diagnosis (97; 31%), followed by migraine (37; 11.8%). None of our patients had a brain tumor, 7 had pseudo tumor cerebri and 2 had bacterial meningitis. There was no difference in final diagnosis between the occipital and non-occipital groups.
Conclusions: The most common causes of occipital headaches are viral infections and primary headaches. Serious intracranial disorders presenting solely as occipital headaches and not accompanied by other neurological signs are uncommon. Thus, occipital headaches should be evaluated in the same manner as other headache locations.
