Abdominal binders

Sklar and colleagues2 describe their experience managing "over-shunting headaches" with an abdominal binder. Seventy children with over-shunting headaches complied with application of a binder for about 1 month. In 61 patients (87%), the headaches "greatly improved or went away." This headache relief persisted even after use of the binder was discontinued. Among the 61 patients with relief, 36 (59%) eventually had recurrent headaches, but the recurrence was delayed (mean 1.5 years). Twenty-nine of these tried the binder again and among the 19 with follow-up, the binder was again effective in 15. These are interesting results. Children with chronic headaches and small ventricles can be very difficult to treat, often undergo repeated surgical interventions, and may have a poor quality of life. Anything that might help them is welcome, especially a simple noninvasive intervention.