Headaches are a very common complaint. By the age of 7, 40 per cent of children have had a headache, and this figure rises to 75 per cent by the age of 15. Parents may worry that the pain is due to a serious condition, such as meningitis or a brain tumour. However, these conditions are extremely rare. Headaches often occur on their own but may accompany any infection that causes a fever. They can also be a symptom of a number of relatively minor disorders. Consult this chart if your child complains of a headache with or without other symptoms. Always consult your doctor if a headache is severe, persistent, or recurs frequently, or if this is the first time that your child has had a particular type of headache.
Warning
Danger signs Call an ambulance if your child has a severe headache accompanied by any of the following symptoms:
Possible cause Meningitis, inflammation of the membranes surrounding the brain due to infection, may be the cause of these symptoms.
Action If meningitis is suspected, your child will be admitted to hospital immediately. He or she will be given urgent treatment with antibiotics and may need intensive care.
14
Possible cause Feverish illnesses are often accompanied by headaches.
Possible cause Your child's head injury may have resulted in damage to the brain.
Action Once in hospital, your child will be observed closely and may have tests such as CT scanning to determine the treatment.
16
Possible cause A mild headache for a while after a bump on the head is not usually a cause for concern.
Action Give your child paracetamol for the pain. Watch him or her closely. If he or she seems unwell, vomits, seems drowsy, or develops any of the danger signs listed above, call an ambulance.
17See your doctor within 24 hours
Possible cause Headaches with these characteristics may be an indication that there is a serious brain disorder.
Action Your doctor may arrange for your child to be seen urgently in hospital for tests such as MRI or CT scanning to establish the cause and appropriate treatment.
18
Possible cause A severe headache associated with these symptoms may be a migraine, particularly if other members of the family also suffer from migraines. Consult your doctor.
Action Your doctor will probably examine your child to exclude other possible causes. Symptoms can often be eased by self-help measures, such as taking a painkiller and an antiemetic (drug that relieves nausea), drinking plenty of fluids, and resting in a darkened room. You should also try to discover whether there are any specific triggers, such as a food or an activity (seeReducing the frequency of migraine).
19Call your doctor now
Possible cause If your child is not well between headaches or his or her performance at school has worsened recently, it may be an indication of a serious brain disorder that needs urgent investigation.
Action Your doctor will examine your child and may arrange for him or her to be seen urgently in hospital for tests such as MRI or CT scanning in order to establish the cause.
20
Possible cause Previously unrecognised eyesight problems may sometimes cause a child to develop a headache after activities such as these. Take your child to an optometrist for an eyesight test.
Action The optometrist will carry out a full sight test and, if a vision problem is found, will prescribe appropriate glasses for your child. If vision is normal, the optometrist will refer your child to the doctor, who will try to establish a cause for the headaches.
21
Possible cause Sinusitis (inflammation of the membranes lining the air spaces in the skull) may be the cause of this type of headache, especially if your child recently had a cold or a runny or blocked nose. Children under 8 are rarely affected as their sinuses have not yet developed.
Action Give your child paracetamol for the pain. Steam inhalation (seeTreating a child with a cold) may also help. If your child is no better after 2 days, see your doctor within 24 hours; your child may need antibiotics.
22
Possible cause Anxiety is one of the most common causes of headaches in children.
Action Discuss your child's problems and worries with him or her, and see if you can identify a pattern to the headaches. Approach teachers for further information. Consult your doctor if you and your child cannot sort out the problem or if the headaches are frequent.
23
Possible cause and action Certain drugs can cause headaches as a side effect. Consult your doctor. Meanwhile, your child should not stop taking the prescribed drugs.
24
Possible cause and action You should bring any frequent or unusual headaches to your doctor's attention. They are unlikely to be serious, but your doctor will want to rule out the possibility of an underlying disorder.
25
Consult your doctor if you are unable to make a diagnosis from this chart. If the headache is severe, call your doctor now.
Self-Help Relieving a child's headache
Headache relief
Encouraging a child to have a sleep or a rest, after first taking a painkiller, will often help to relieve his or her headache.
Most childhood headaches can be treated without the need for medical help. Try the following self-help measures to relieve the pain.
If the headache persists for more than 4 hours, if your child seems very unwell, or if other symptoms develop, call your doctor.
Family Doctor Health Advisor is for information purposes only, and is designed as a general reference and catalyst to seeking further information.
The RACGP is not engaged in providing medical or other advice or services, and is not responsible for the results of any actions taken by any person on the basis of any information in this publication, or for any error in, or omission from, this publication.
Publication Date: 31 March 2009 Authorised By: RACGP
