Headaches are common complaints in the Pediatric office practice. Although headaches are usually not associated with serious medical conditions but a careful clinical assessment is necessary to identify specific clues for the underlying illness. Its important to elicit the exacerbating factors and triggers for headache.
Common causes of headache are acute symptomatic due to viral infection, primary headache disorder like tension type headache and migraine.
The ominous causes like meningitis, tumours, sinus thrombosis, etc are less common and these conditions usually has additional clinical signs to suggest this.
Red flag signs for a headache
Acute and severe headache
Progressive course
Altered mental status
Abnormalities on neurologic examination
Sleep-related headaches
Worsening with exertion, Valsalva, or positional changes
Comorbid seizures
Features of systemic disease present
Any Recent change in an established headache pattern
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