HEALTH INSIGHTS

Headache

By M.D. Barton D. Schmitt 
 | 
April 15, 2010

911 warning

Headache

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Does this describe your child's symptoms?

Definition

  • Pain or discomfort of the scalp or forehead areas

  • The face and ears are excluded

Causes

  • Viral illnesses: Most headaches are part of a viral illness, especially with colds. These usually last a few days.

  • Muscle tension headaches: Most common type of recurrent headaches. Muscle tension headaches give a feeling of tightness around the head. The neck muscles also become sore and tight. Tension headaches can be caused by staying in one position for a long time, such as with reading or using a computer. Other children get tension headaches as a reaction to stress, such as pressure for better grades or family disagreements.

  • Migraine headaches: Recurrent severe, incapacitating headaches

  • Other common causes: Hunger, exertion, sunlight, coughing

  • Frontal sinusitis: can cause a frontal headache just above the eyebrow.  Rare before 10 years old because frontal sinus not developed.  Other sinuses cause face pain, not headache.

  • Serious causes: Meningitis or encephalitis. Symptoms include a headache, stiff neck, vomiting, fever and confusion.

If not, see these topics

  • Followed a head injury within last 3 days, see HEAD INJURY

  • Pain is around the eye or the cheekbone, see SINUS PAIN AND CONGESTION

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When to Call Your Doctor

call 911

Call 911 Now (your child may need an ambulance) If

  • Difficult to awaken or passed out

  • Confused thinking/talking or slurred speech

  • Blurred or double vision

  • Weakness of arm or leg or unsteady walking

call now

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick

  • Stiff neck (can't touch chin to chest)

  • Severe headache

  • Vomiting

  • You think your child needs to be seen urgently

call within 24 hours

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen, but not urgently

  • Fever

  • Sinus pain (not just congestion) of forehead

call within 24 hours

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

  • Headache without other symptoms present over 24 hours

  • Sore throat present over 48 hours

  • Any headache present over 3 days

  • Headaches are a recurrent chronic problem

home care

Parent Care at Home If

  • Mild headache and you don't think your child needs to be seen

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HOME CARE ADVICE FOR HEADACHES

Treatment for Mild Headache

  1. Reassurance:

    • Headaches are very common with viral illness, especially with colds. They usually resolve in 2 or 3 days.

    • Unexplained headaches can occur in children, just as they do in adults. They usually pass in a few hours or last up to a day.

    • Most headaches (including muscle tension headaches) are helped by the following measures.

  2. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief (see Dosage table). Headaches due to fever are also helped by fever reduction.

  3. Food: Give fruit juice or food if your child is hungry or hasn't eaten in more than 4 hours (Reason: Skipping a meal can cause a headache in many children).

  4. Rest: Lie down in a quiet place and relax until feeling better.

  5. Local Cold:  Apply a cold wet washcloth or cold pack to the forehead for 20 minutes.

  6. Stretching: Stretch and massage any tight neck muscles.

  7. Call Your Doctor If:

    • Headache becomes severe

    • Vomiting occurs

    • Isolated headache lasts over 24 hours

    • Headache lasts over 3 days

    • Your child becomes worse

  8. Extra Advice - Muscle Tension Headache Prevention:

    • If something is bothering your child, help him talk about it and get it off his mind.

    • Teach your child to take breaks from activities that require sustained concentration. Encourage your child to do relaxation exercises during the breaks.

    • Teach your child the importance of getting adequate sleep.

    • If over-achievement causes headaches, help your child find more balance.

    • Caution: Your child should have a complete medical checkup before you conclude that recurrent headaches are due to worrying too much or stress.

Treatment for Migraine Headache

  1. Reassurance: This headache is similar to previous migraine headaches that your child has experienced.

  2. Migraine Medication:

    • If your child's doctor has prescribed a specific medication for migraine, give it as directed as soon as the migraine starts.

    • If not, ibuprofen is the best over-the-counter drug for migraine. Give ibuprofen now and repeat in 6 hours if needed (See Dosage Table).

  3. Sleep: Have your child lie down in a dark, quiet place and try to fall asleep. People with migraine often awaken from sleep with their migraine gone.

  4. Prevention of Migraine Attacks:

    • Stay well hydrated.

    • Don't skip meals.

    • Get adequate sleep each night.

  5. Call Your Doctor If:

    • Headache becomes much worse than usual

    • Headache lasts longer than usual

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Updated:  

February 21, 2012