[Venous angiomas and headache in children. A case report]

Abstract

Introduction: Venous angiomas (VA) are benign entities; however infrequent symptomatic cases may occur.

Objective: Case report and literature review.

Case report: A 6 year old girl was referred with a history of bi-frontal, non-pulsatile, headache with no nausea or vomiting. Headache intensity was 4-6/10. The episodes were frequent, 3-4 times per week. Triggers include academic work. Computed tomography showed a small VA in left caudate nucleus, which was confirmed by a brain MRI, with no evidence of inflammatory or ischaemic changes, or another vascular malformation. Psychological and psycho-pedagogic techniques were used, combined with relaxation and cognitive-behavioural techniques to reduce the intensity and frequency. There was a good outcome, and the headache decreased to 10 episodes per year. The patient was monitored for 12 years until graduation from high school. The VA remained without complications.

Conclusions: In the study of a headache, a VA usually is an incidental finding. The International Classification of Headache Disorders III provides specific criteria of frequent episodic tension-type headache, and allows us begin specific therapy for it. Monitoring of non-symptomatic VA cases should be clinical. The surgical management of these entities is exceptional.

Keywords: Angioma venoso; Anomalía del desarrollo venoso; Cefalea; Cefalea tensional; Developmental venous anomaly; Headache; Paediatrics; Pediatría; Tension-type headache; Venous angioma.