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小児の頭痛の種類と危険性について

小児

小児の頭痛については大人がしっかりと気づいてあげることが重要となります。小児の場合、体調の不良等があってもそれを十分に大人に伝えることができません。頭痛も大人にしっかりと伝えることができない場合もありえますので、大人の方から配慮してあげることが重要です。また、ごく稀ですが小児の頭痛が重い病気の症状として表れることもあるので注意が必要となります。

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小児の頭痛に耳を傾ける

子供

小さな子供(以下、便宜上「小児」といいます。主として小学校入学前までのお子さんを指して小児と呼ぶことにします)は体調の不調があっても、十分にその不調を訴えることができません。特に幼稚園に入学したばかりのようなまだまだ幼い小児の場合、言葉はもちろん仕草でも十分に体調の不良を訴えることができない場合もります。

このような場合には、親御さんが小児の様子がいつもと違うことなどに注意して体の不調に気づいてあげることが必要となります。

大人の問いかけ(あるいは自発的な訴え)により小児が訴えることができる主要な症状としては、腹痛の他に頭痛があります。小児が「頭が痛い」などと言って頭痛を訴えた場合にはどのような病気の可能性が考えられるのでしょうか。

小児が頭痛を訴える場合

小児が頭痛を訴えた場合には、主として以下のような病気の可能性が考えられます。38

風邪による頭痛

小児が頭痛を訴えた場合、最も可能性として高いものとしては、やはり風邪による頭痛の可能性が高いということができます。風邪による頭痛は、大人でも小児でも発症する代表的な症状の一つということができるためです。

ただ、小児の風邪の頭痛の場合、抵抗力が低いことから肺炎など重い病気につながってしまう可能性がありますので、早めに風邪であることを見抜き、病院へ連れて行くことなどが重要です。小児が頭をおさえているような場合には「頭が痛いの?」などと訪ねて頭痛の症状を持っているかを確かめてあげることなどが重要です。もちろん、病院でも頭痛を訴えていることを医師に伝えることが大切です。

偏頭痛による頭痛

偏頭痛は、日本人の8パーセントが持つ頭痛です。一般に頭痛持ちといった場合には、偏頭痛を指すこととなります。偏頭痛は頭の両側面がズキンズキンと痛み、はきけやめまいなどを伴い大変つらい頭痛です。この偏頭痛は小児のうちから発症することもあります。

小児の偏頭痛の場合には、症状が嘔吐や下痢などを伴い、大変重いものに見えるのが特徴です。しかし、一方で小児の場合には偏頭痛の症状が短時間でおさまってしまうという特徴もあります。(大人の偏頭痛の場合には、長い方では3日程度も頭痛が続く場合もあります)小児の偏頭痛の場合には、嘔吐や下痢などを伴うことから風邪などと勘違いしてしまうこともありえますが、医師の診断により偏頭痛と分かることもあります。

現在、偏頭痛の根本的な理由や治療方法は発見されていません。ただ、偏頭痛を生じた場合に、痛みを予防したり軽減するための薬などは開発されています。そのため、小児のうちに偏頭痛を発症したような場合には、早めに薬を飲む習慣などを小児に覚えさせて、偏頭痛の管理ができるように指導することが重要となります。

ごくまれにありえる重篤な小児の頭痛

小児の頭痛がごくまれに極めて重い病気の症状の表れである可能性がありえます。これは主として小児が生まれつき、先天的に持っている病気が原因の場合です。例えば、小児のうちから脳腫瘍を発症することがあります。小児の脳腫瘍は、特に、小児脳腫瘍などと呼ばれます。

小児脳腫瘍の場合には、頭痛が朝方に発生することが多いのが特徴です。また頭痛に伴いはきけが生じます。先天的に持っていた腫瘍などが大きくなるに従い、症状はひどくなります。さらに症状が進むとけいれん発作や麻痺などが起きることもあります。

小児脳腫瘍の場合には、大学病院などの専門性が高い治療を施してくれる病院において専門手術を受けることなどが必要となります。小児脳腫瘍などを持ってしまうことはまれですが、頭痛が小児脳腫瘍の発見の糸口となることもありますので、小児が頭痛やはきけなどをずっと訴え続ける場合には、小児脳腫瘍を発見するきっかけとなる場合もあります。

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まとめ:小児の頭痛は大人がしっかりと気づいてあげたい

以上、本文で述べました小児の頭痛に関してのポイントをまとめますと以下のようになります。

  • 小児の場合、頭痛を明確に大人に告げることができない場合があります。そのため、親御さんなど周りの大人が頭痛であるかを尋ねるなどして体調不良を見抜いてあげることが重要です
  • 小児の頭痛の場合、多くのケースでは風邪の症状などあまり心配がいらない場合が多いと言えます。ただ、病気が重くならないよう早めに病院へ連れて行くことが重要です。また、小児の頭痛が偏頭痛の始まりである場合もありえます
  • ごくまれに小児脳腫瘍などの重篤な病気の症状として頭痛を訴える場合もありえます

小児の頭痛に関しては大人が気づいてあげることが何より大切ということができます。
小児はまだまだ体調管理も含めて親がしっかりと見てあげたいものです。

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