"Nurse, my head hurts": a review of childhood headaches

Headache, a frequent occurrence during childhood, can have a number of etiologies. Most headaches are benign, but all require appropriate assessment. Common types include sinusitis, migraine, and muscle contraction (tension). Headache assessment includes both history and physical examination. The headache history consists of the history of present illness, past history, family history, and environmental and social history. Physical examination begins with general observation and vital sign measurement and proceeds to specific inspection of the head, neck, and facial structures. The nursing interventions carried out are dependent on the interpretation of assessment findings. Pharmacologic interventions, commonly acetaminophen or ibuprofen, may be appropriate if pain management protocols exist. Nonpharmacologic strategies for headache relief include reassurance, rest, ingestion of simple and complex carbohydrate foods, relaxation exercises, or home care. Children with migraine headaches benefit from specific interventions, and children exhibiting headache warning signs should have emergency measures instituted.