Robert Wood Johnson University Hospital
 

Headaches

Headaches

What is a headache?

A headache is pain or discomfort in the head or face area. Headaches vary greatly in terms of pain location, pain intensity, and how frequently they occur. As a result of this variation, several categories of headache have been created by the International Headache Society (IHS) to more precisely define specific types of headaches.

According to the American Academy of Pediatrics, almost two out of three teens will complain of a headache each month.

What aches when your child has a headache?

There are several areas in the head that can hurt when your child has a headache, including the following:

The bones of the skull and tissues of the brain itself do not hurt because they do not have pain-sensitive nerve fibers.

What causes a headache?

Headaches may be caused by a number of conditions, such as disorders of the neck, eyes, brain, jaw, or teeth. Headaches with an underlying medical condition are classified as secondary headaches because they are related to the condition. An example of this would be a headache due to neck injury or sinus infection.

The majority of headaches experienced by children and adolescents are not due to serious underlying problems. Both physical and emotional factors must be considered when evaluating headaches.

Headaches classified as primary indicate that the headache itself is the main medical problem, although underlying nonmedical causes, such as muscle tension or foods, may be identified. Other contributing factors may include medications, dehydration, or changing levels of hormones. These factors that influence headaches are sometimes called headache triggers.

What are the most common types of primary headaches in children?

What are some important points to consider regarding your child’s headache?

Headache symptoms depend upon the type of headache. The frequency of headaches and the intensity of the symptoms may vary as well. Symptoms and situations that may suggest the need to contact your child’s physician include any of the following:

The symptoms of a headache may resemble other conditions or medical problems. Always consult your child’s physician for a diagnosis.

How are headaches diagnosed?

The full extent of the problem may not be understood immediately, but may be revealed with a comprehensive medical evaluation and diagnostic testing. The diagnosis of a headache is made with a careful history, physical examination and diagnostic tests.

Questions commonly asked during the exam may include the following:

If the history is consistent with migraine or tension type headaches and the neurological exam is normal, no further diagnostic testing may be necessary. However, if it is not a primary type headache, then other tests may be needed to determine the cause.

Tests used to determine the cause of your child’s headache may include:

Treatment for headaches:

Specific treatment for headaches will be determined by your child’s physician based on:

The ultimate goal of treatment is to stop headaches from occurring. Adequate headache management depends on the accurate identification of the type of headache and may include:

Migraine headaches may require specific medication management including:

Some headaches may require immediate medical attention including hospitalization for observation, diagnostic testing, or even surgery. Treatment is individualized depending on the underlying condition causing the headache. Full recovery depends on the type of headache and other medical problems that may be present.

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