Don’t ignore persistent morning headache and vomiting in kids

Couple of weeks back Adar a seven years old apparently healthy boy came to me with his parents having a history of headache, nausea, vomiting, vision problem for the last three months. These symptoms are more prominent in the morning prior to go to school. Parents thought that Adar doing these just to avoid school and thus they ignored it. Recently his mother noted that his walking is not well coordinated as it was before. After meticulous examination it reveled that he has developed some neurological deficit. Examined his fundus (inside back of the eye) I found papilloedema (swelling of optic disc that is caused by increased intracranial pressure). After a CT scan of brain diagnosis was confirmed as brain tumor.
Brain tumor is the second most common malignant condition of children and adolescent. It is next to leukemia.
In Brain tumor symptoms and signs are produced because of increased intracranial pressure (pressure inside skull and thus in the brain tissue and cerebrospinal fluid) and focal brain dysfunction. Common signs and symptoms include headache, nausea, vomiting, vision and speech problem, problem with walking and coordination. There may be focal seizure and cranial nerve palsy.
Symptoms appear slowly but it is progressive. Early diagnosis and prompt treatment is very important to avoid complications.
Surgery and radiotherapy is the mainstay of treatment. Now a days there are many competent and skilled neurosurgeons available in Bangladesh. They are doing these brain surgery in district level hospitals with very good outcome.
Please do not neglect persistent morning headache and vomiting of your child. Be happy and healthy always.

The author is a Professor of Paediatrics of Community Based Medical College (CBMC) Hospital, Mymensingh. Email: [email protected]