Kids' Headaches: The Diagnosis Is Difficult
Headaches aren't only for adults. Kids get them, too. By the time children reach high
school age, most have had some type of headache.
There are 2 basic types of headaches. Primary headaches have the headache as the only
symptom. It will stop once treated. Secondary headaches are caused by some other health
problem. They don’t often go away until the health problem is treated.
Primary headaches include tension-type and migraine headaches. Hundreds of health
problems or circumstances can cause headaches. These can span the range from not harmful
to very serious. They include dehydration, hunger, lack of sleep, infections, caffeine,
medicines, hormonal changes, stress, allergies, head injury, meningitis, brain aneurysm,
and tumor. Fortunately, most headaches in kids are not caused by serious problems.
Your child's healthcare provider can determine what kind of headache your child has. They will
need to talk to both you and your child to see if the headache has an emotional side
to it. They will also do a complete physical exam along with a neurological exam.
Sometimes your child will need brain imaging in the form of either a CT scan or MRI.
Your child's healthcare provider will advise you when it's necessary to do brain imaging
and which test is best for your child.
This is the most common type of headache in children. The most likely causes are emotional
upsets or stress. Your child may describe the pain as widespread or like a tight band
around the head. This type of headache does not often cause nausea and vomiting. It's
also not tied to other symptoms, such as fever, change in mental status, or other
Tension headaches are almost always linked to stressful situations at school, competition,
family friction, or too many demands by parents. The healthcare provider needs to
also find out whether anxiety or depression may be present.
These headaches are often easily treatable with over-the-counter medicine, such as
acetaminophen or ibuprofen. Your healthcare provider will tell you how to give these medicines
safely. It's also important to identify likely triggers and make lifestyle changes
in diet, sleep patterns, exercise, and study habits.
A migraine headache is sometimes one-sided and throbbing. It's sometimes occurs with
nausea and vomiting, or sensitivity to light, noise, or both. Some migraines are preceded
by aura, which are often one-sided sensory changes that point to the start of a migraine. Children
who have a family history of migraines have a greater chance of getting migraines
themselves. The younger the child, the harder it is to make the diagnosis of migraine
headaches. Fortunately, migraines may go away in some children several years after
they appear. But many children who get migraine headaches will go on to have them
during the rest of their lives. Research has shown that symptoms will have happened
in about a fourth of migraine sufferers before age 5, and in about half before age
It's important to realize that a migraine headache may happen after a head injury,
especially after injury in sporting activities like football and baseball. The child
will often recover fully over time.
Migraine headaches are treated in two ways. Medicines can be used to stop an acute
migraine headache. Other medicines can be used to prevent frequently occurring headaches.
Your healthcare provider will advise you on the correct medicines you can give to
best control the symptoms of your child's migraine headaches.
These headaches need medical care right away:
A headache in a child who has had a blow to the head or a recent history of head trauma.
This is especially true if the headache is steadily getting worse.
A headache with fever, nausea or vomiting, confusion, significant sleepiness or loss
of consciousness after the headache starts, stiff neck, changes in vision, seizures
or fainting episodes, or skin rash.
A headache that comes on quickly and seems to be the worst headache the child can
possibly imagine having. Watch for this, especially if the child has a history of
never having headaches.