Primary headaches in adolescents

Glavobolje su vrlo česte u razdoblju adolescencije. One imaju negativan utjecaj na učenje, izvršavanje školskih i izvanškolskih obveza, na odnose s vršnjacima i razlog su čestog izostajanju s nastave. Prema trećem izdanju Internacionalne klasifikacije glavobolje iz 2013. godina glavobolje su podijeljene u primarne i sekundarne. Primarne glavobolje u adolescentsko doba su migrena i tenzijska glavobolja, a od trigeminalnih autonomnih glavobolja javlja se, iako izrazito rijetko, cluster glavobolja. Migrenska glavobolja karakterizirana je unilateralnom, pulsirajućom boli u području čela, oka i sljepoočnice, a u ranoj adolescenciji bol može biti i bilateralna. Popraćena je mučninom, povraćanjem, fotofobijom i fonofobijom. Kod tenzijske glavobolje bol je bilateralna, tipa pritiska ili stezanja obruča i ne pojačava se rutinskom tjelesnom aktivnošću. Mučnine i povraćanja obično nema, a fotofobija ili fonofobija mogu biti prisutne, ali ne obje. Cluster glavobolju karakterizira periodičko pojavljivanje jake boli obično locirane orbitalno, supraorbitalno ili temporalno, udružene s ipsilateralnim autonomnim simptomima i osjećajem nemira i agitacije. Stručnjaci su još uvijek podijeljeni oko patogenetskih mehanizma nastanka primarnih glavobolja. Dijagnoza se bazira na anamnezi i kliničkoj slici. Cilj terapije je klasificirati tip glavobolje, objasniti roditeljima i adolescentu prirodu bolesti te poboljšati kvalitetu života. U liječenju primarnih glavobolja, osim farmakoterapije bitna je i promjena stila života. Važna je uloga psihologa, relaksirajućih treninga i biofeedbacka. Pravodobno i pravilno liječenje čini bolest podnošljivijom. Cilj je ovog preglednog rada dati prikaz primarnih glavobolja u adolescentsko doba, naglasiti njihove kliničke manifestacije te predstaviti nove diferencijalno dijagnostičke kriterije (ICHD-3 2013) i metode liječenja.Headaches are very common during the period of adolescence. They have negative impact on studying, their performance in curricular and extracurricular activities, relations with their peers and, they are also the reason of frequent lesson absence. According to The International Classification of Headache Disorders 3rd edition (beta version) published in 2013., headaches are divided in primary and secondary headaches. Primary headaches in adolescence are migraine and tension-type headache, and among the trigeminal autonomic cephalgias (TACs), cluster headache occurs, but extremely rarely. Migraine headache is characterized by unilateral, pulsating pain in the area of the forehead, eye and temples. It is accompanied by nausea, vomiting, photophobia and phonophobia. In tension-type headache the pain is bilateral, pressure type or constricting type and it does not increase with routine physical activity. Usually, nausea and vomiting are not present, photophobia and phonophobia can be present but not both at the same time.Cluster headache is characterized by a periodic appearance of very strong pain, usually located orbitally, supraorbitally or temporally,associated with ipsilateral autonomal symptoms and feeling of restlessness and agitation. Experts are still divided about the pathogenic mechanisms of the development of primary headaches. Diagnosis is based on anamnesis and clinical manifestation. The goal of the therapy is to classify the type of headache, explain the nature of the disease to parents and adolescent as well as improve the quality of life. In treatment of primary headaches, other than the pharmacotherapy, it is very important to change the lifestyle. Also, the role of the psychologist, relaxation trainings and biofeedback, is important. Proper treatment on time makes the disease tolerable. The goal of this review is to give an overview of primary headaches in adolescence, to outline their clinical manifestations as well as present new differential diagnostic critera (ICHD-3 2013) and treatment methods