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Published on: June 2, 2014
A guide to children with acute and chronic headaches
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.
Abstract:
Children with acute and chronic headaches are often seen by primary care providers. A complete, elaborate history, obtained from both the parents and child, is key in diagnosing and managing the child who presents with a headache. A thorough social and educational history may reveal significant school or family stresses. Historic features of concern must be explored immediately. A thorough physical examination with a focused neurologic examination must be done Focal neurologic findings may indicate serious organic problems. A comprehensive approach to the management of headaches in children consisting of reassurance, education, pharmacologic interventions, and nonpharmacologic interventions is presented. A two-tiered management plan is used in conjunction with medications. The aim of this article is to provide the novice or experienced practitioner with a comprehensive review of acute and chronic headache pathogenesis, assessment, and management. This review includes migraines and other nonmigraine types of headaches.
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