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- Heidi K. Blume, MD, MPH
- Division of Pediatric Neurology, Seattle Children’s Hospital and Research Institute, Seattle, WA.
Author Disclosure
Dr Blume has disclosed no financial relationships relevant to this article. This commentary does contain a discussion of an unapproved/investigative use of a commercial product/device.
- CSF:
- cerebrospinal fluid
- ICH:
- intracranial hemorrhage
- ICP:
- intracranial pressure
- IIH:
- idiopathic intracranial hypertension
- NDPH:
- new daily persistent headache
- NSAID:
- nonsteroidal anti-inflammatory drug
- SVT:
- sinus venous thrombosis
- TAC:
- trigeminal autonomic cephalalgia
Educational Gap
Headaches are common in children; while most are caused by a benign problem or primary headache disorder, headaches can be a sign of a serious underlying condition. Pediatricians must be aware of the most recent recommendations for evaluating and managing headaches.
Objectives
After reading this article, readers should be able to:
Understand the evaluation of a child who has headache.
Recognize the diagnostic criteria for pediatric migraine.
Recognize “red flags” for elevated intracranial pressure or other underlying conditions in the child who has headache.
Discuss treatment strategies for migraine, tension, and chronic headache disorders.
Introduction
Headaches are common in children and adolescents and are a frequent chief complaint in office and emergency department visits. The vast majority of childhood headaches are due to a primary headache disorder, such as migraine, or an acute, relatively benign process, such as viral infection. However, clinicians also need to consider other causes of headaches in children. Even when headaches are benign, they may cause significant dysfunction for the child and family and must be managed appropriately to minimize disability and optimize function. In this review, we discuss the epidemiology of childhood headache, evaluation of the child who has headaches, when to consider secondary headache syndromes, and the diagnosis and management of primary headache disorders such as migraine and tension-type headaches.
Epidemiology of Childhood Headache
Acute and chronic headaches are relatively common in children and adolescents, although estimates of the precise prevalence of headache and migraine vary widely. Depending on the study definition of headache, population involved, and time periods studied, 17% to 90% of children report headaches, with an overall prevalence of 58% reporting some form of headache in the past year. (1 …
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- Article
- Educational Gap
- Objectives
- Introduction
- Epidemiology of Childhood Headache
- Childhood Headache Patterns
- Primary Headache Syndromes
- Secondary Headaches
- Infection
- Structural Disorders
- Vascular Disorders
- Trauma
- Substances That Can Cause Headache
- Systemic Disease and Headache
- Evaluation of Headache in Children
- Management of Primary Headache Syndromes
- References
- Figures & Data
- Info & Metrics
- Comments
- Quiz