Evaluating Headaches in Pediatric Patients

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

Next post – When to Ask for Neuro Imaging in Headaches?

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