Health & Fitness

Take children’s headaches seriously

Dr. Allen Kantrowitz, chief of the division of neurology at Mount Sinai Medical Center, demonstrates Chiari malformation type 1, at the junction of the brain and cervical spine.
Dr. Allen Kantrowitz, chief of the division of neurology at Mount Sinai Medical Center, demonstrates Chiari malformation type 1, at the junction of the brain and cervical spine. MIAMI HERALD STAFF

Chonjaé Trobridge used to resist to the urge to laugh or feeling any extreme emotion because she knew it’d result in a painful headache.

The headaches began when she was about 10 and at times were so severe, they caused Trobridge to pass out. Her mom didn’t believe that she was sick — thinking she was faking to get out of school — and doctors were unable to fully treat the culprit, a condition called a Chiari Malformation, until about a decade after her first episode.

“I’m doing much better,” said Trobridge, who had surgery in 2013 at Mount Sinai Medical Center.

It was a long journey to get a diagnosis, and now, Trobridge has a message to parents with children with headaches: Take them seriously.

And those in the medical profession echo her view.

“Headaches in children are different than headaches in adults,” said Dr. Diana Martinez, chief pediatric neurologist at Joe DiMaggio Children’s Hospital, part of Memorial Healthcare in Broward. “They can happen because a child is sick, it can be something like a brain tumor or a Chiari Malformation.”

Martinez points out that the root cause of a headache can often vary and that some red flags parents should look out for in children are when they have a headache accompanied by neck pain or vomiting.

In addition, if a headache is causing a child to wake up while sleeping, or if a child is waking up with a headache in the morning, those may be signs that the child should see a physician.

So how do you tell if a child is faking? One clue is their behavior.

“Most of the time, if a child has a headache that is bad, the parent is going to see a change in behavior,” Martinez said. “The child is going to be less active, not want to open the iPad, play video games.”

Dr. Allen Kantrowitz, the chief of the division of neurosurgery at Mount Sinai Medical Center, is the one who figured out that Trobridge’s headaches were caused by a Chiari Malformation, which is a structural defect in the cerebellum — the part of the brain that controls balance.

In Trobridge’s case, the malformation caused her to have an increased number of headaches that could have been caused by a cough or even laughing too hard.

“The difficulty is that we all have headaches, and we all have several kinds of headaches, and so it’s for a neurologist to sort through the different kinds of headaches a patient may be experiencing,” Kantrowitz said.

Kantrowitz said headaches associated with Chiari tend to be localized where the neck meets the skull.

To treat this condition, Kantrowitz performs a surgery targeted at the junction of the brain and the cervical spine. To treat Trobridge, he made a roughly 10 millimeter incision, or 0.39 of an inch, in that area to relieve her of any issues.

Kantrowitz said the surgery gives the brain enough space, adding that the surgery “changed her life.”

And it did. Trobridge is now able to laugh out loud and live an easier lifestyle.

“I like to dance, and I couldn’t dance before without my head starting to hurt,” Trobridge said. “Now I can enjoy the things I’ve missed out on.”

Prior to be diagnosed, Trobridge used to pop painkillers to get through the day and avoided going out with friends in case her headaches flared.

“I used to dance, and I had to cut that out. There was a dance team at school, and I couldn’t do it, it was frustrating,” said Trobridge, who attended Miami Northwestern High School and graduated from North Miami Senior High School.

She failed classes, and when it came to college at Miami Dade College, she ended up losing financial aid because of missing classes due to her headaches.

“I didn’t have a medical excuse; I didn’t have a doctor’s note,” said Trobridge, who plans to reenroll to purse her dream of becoming a forensic anthropologist.

There are various types of Chiari Malformations. Types two and three are typically caught at birth and treated right away. Trobridge has Type one, which doesn’t present until later, leaving her to go to an adult neurosurgeon to treat the problem.

Martinez encourages parents to take a child to a specialist if they notice signs of severe headaches, or if a child who typically doesn’t have headaches starts having them.

“I’d rather be safe than sorry,” she said. “Especially with children under 6 because they typically don’t complain of headaches. I think the message to parents is that if your gut feeling is that something is not right, get it checked out.”