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Headache in the pediatric emergency department
1Division of Pediatric Neurology, Children's Hospital of the King's Daughters, Eastern Virginia Medical School, Norfolk 23510, USA.
Insights
Headache is a common emergency department complaint in children. This review outlines how to evaluate nontraumatic pediatric headaches, distinguishing benign cases from serious conditions.
Area of Science:
- Pediatric Emergency Medicine
- Neurology
- Clinical Evaluation
Background:
- Headache is a frequent reason for pediatric emergency department visits.
- While most pediatric headaches are benign, some may indicate serious underlying pathology.
- A structured approach is crucial for accurate diagnosis and management.
Purpose of the Study:
- To review the etiology of nontraumatic headaches in pediatric patients.
- To outline an evidence-based evaluation strategy for pediatric headache in the emergency setting.
- To guide appropriate diagnostic investigations for nontraumatic pediatric headaches.
Main Methods:
- Literature review of nontraumatic pediatric headache causes.
- Synthesis of current guidelines for emergency department evaluation.
- Discussion of diagnostic tools and their utility.
Main Results:
- Common causes of pediatric headache include migraines and tension-type headaches.
- Red flags for serious conditions such as meningitis or intracranial hemorrhage are identified.
- Diagnostic workup should be guided by clinical presentation and suspected etiology.
Conclusions:
- A systematic approach to pediatric headache evaluation in the emergency department is essential.
- Differentiating benign from dangerous headaches ensures timely intervention for critical conditions.
- Appropriate use of investigations aids in accurate diagnosis and management of pediatric headaches.
Abstract:
Headache is one of the most common presenting complaints to emergency departments. Although the overwhelming majority of these headaches are benign and self-limited, headache can be the initial symptom of life-threatening disorders. It is therefore essential for physicians to have a rational approach to the evaluation of a child or adolescent who presents to the emergency department with headache. The purpose of this article is to review the causes, evaluation, and appropriate investigations for nontraumatic headache in the pediatric emergency department.