A guide to children with acute and chronic headaches

R K Rosenblum1, P G Fisher

  • 1Division of Pediatric Neurology, Lucile Salter Packard Children's Hospital, Stanford University Medical Center, CA 94305-5235, USA. ruthrose@stanford.edu

Insights

Diagnosing and managing pediatric headaches requires a thorough history and physical exam. This review covers acute and chronic headache causes, assessment, and treatment options for primary care providers.

Area of Science:

  • Pediatrics
  • Neurology

Background:

  • Headaches are common in children presenting to primary care.
  • Accurate diagnosis relies on detailed patient and parent history.
  • Identifying stressors is crucial for effective management.

Purpose of the Study:

  • To provide a comprehensive review of pediatric headaches.
  • To guide practitioners in assessment and management strategies.
  • To cover both migraine and non-migraine headache types.

Main Methods:

  • Review of current literature on pediatric headache.
  • Emphasis on detailed history taking (social, educational, medical).
  • Inclusion of physical and focused neurologic examination findings.

Main Results:

  • Focal neurologic findings may signal serious underlying conditions.
  • A comprehensive management approach includes reassurance, education, and interventions.
  • A two-tiered management plan is recommended alongside pharmacologic and non-pharmacologic treatments.

Conclusions:

  • Effective management of pediatric headaches requires a thorough diagnostic process.
  • A multi-faceted approach is essential for optimal patient outcomes.
  • This review equips practitioners with knowledge for diverse headache presentations.

Related Concept Videos

Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
Acute Pharyngitis01:30

Acute Pharyngitis

Introduction
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
Chronic Pancreatitis II: Collaborative Care01:29

Chronic Pancreatitis II: Collaborative Care

The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Attention-Deficit/Hyperactivity Disorder01:30

Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity. It affects approximately 5-8% of children globally, with around 60-70% of cases persisting into adulthood. ADHD has significant implications for educational attainment, social interactions, and occupational success.
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.