To learn about the nature of your child's headache, your doctor will likely look to:
June 26, 2013
- Headache history. Your doctor asks you and your child to describe the headaches in detail, to see if there's a pattern or a common trigger. Your doctor may also ask you to keep a headache diary for a time, so you can record more details about your child's headaches, such as frequency, severity of pain and possible triggers.
- Physical exam. The doctor performs a physical exam, including measuring your child's height, weight, head circumference, blood pressure and pulse, and examining your child's eyes, neck, head, shoulders and spine.
Neurological exam. Your doctor checks for any problems with movement, coordination or sensation.
If your child is otherwise healthy and headache is the only symptom, no further testing usually is needed. In a few cases, however, imaging scans and other evaluations can help pinpoint a diagnosis or rule out other medical conditions that could be causing the headaches. These tests may include:
- Computerized tomography (CT) scan. This imaging procedure uses a series of computer-directed X-rays that provide a cross-sectional view of your child's brain. This helps doctors diagnose tumors, infections and other medical problems that can cause headaches.
- Magnetic resonance imaging (MRI). MRIs use a powerful magnet to produce detailed views of the brain. MRI scans help doctors diagnose tumors, strokes, aneurysms, neurological diseases and other brain abnormalities. An MRI can also be used to examine the blood vessels that supply the brain.
- Spinal tap (lumbar puncture). If your doctor suspects an underlying condition, such as bacterial or viral meningitis, is causing your child's headaches, he or she may recommend a spinal tap (lumbar puncture). In this procedure, a thin needle is inserted between two vertebrae in the lower back to extract a sample of cerebrospinal fluid for laboratory analysis.
- Tintinalli JE, et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=40. Accessed April 15, 2013.
- Headaches in children. American Headache Society. http://www.achenet.org/resources/headaches_in_children/. Accessed April 15, 2013.
- Arruda MA, et al. Frequent headaches in the preadolescent pediatric population: A population-based study. Neurology. 2010;74:903.
- Robberstad L, et al. An unfavorable lifestyle and recurrent headaches among adolescents: The HUNT Study. Neurology. 2010;75:712.
- Seshia SS. Chronic daily headache in children and adolescents. Current Pain and Headache Reports. 2012;16:60.
- Monteith TS, et al. Tension type headache in adolescence and childhood: Where are we now? Current Pain and Headache Reports. 2010;14:424.
- Arruda MA, et al. Cluster headache in children and adolescents: Ten years of follow-up in three pediatric cases. Cephalalgia. 2011;31:409.
- Treatment of migraine headache in children and adolescents. American Academy of Neurology. www.aan.com/practice/guideline/index.cfm?fuseaction=home.view&guideline=159. Accessed April 16, 2013.