Headaches in Children and Adolescents: When Should a More Serious Problem be Suspected?

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Serious medical conditions that may cause a headache include:

  • Brain tumor
  • Abscess (infection of the brain)
  • Intracranial bleeding (bleeding within the brain)
  • Bacterial or viral meningitis (infections)
  • Hydrocephalus (excess cerebrospinal fluid in the brain)
  • Pseudotumor cerebri (increased intracranial pressure)
  • Other causes -- such as trauma to the head or ingestion of toxins (chemicals/poisons)

Diagnosis
A MRI scan (magnetic resonance imaging) and a MRA scan (magnetic resonance imaging of the arteries) are two types of tests your doctor may use to help determine if a serious medical problem is the cause of your child’s headaches. Both of these imaging tests allow the tissues and arteries within the brain to be seen and evaluated. Skull X-rays are not helpful. An EEG (electroencephalogram) is unnecessary unless the child has lost consciousness with his or her headaches. Frequently, a CT scan is ordered if a patient arrives at a hospital’s emergency room.

When to call the doctor

Contact your health care provider if your child:

  • Has a stiff neck or a fever in addition to the headaches
  • Is short of breath, dizzy, has slurred speech, or numbness/tingling with the headaches
  • Has blurred vision, double vision or blind spots with the headaches
  • Has three or more headaches per week
  • Has headaches that keep getting worse and won’t go away
  • Needs to take a pain reliever greater than 3 or 4 times per week for the headaches
  • Needs more than the recommended doses of over-the-counter (nonprescription) medications to relieve headache symptoms
  • Has headaches that are triggered by exertion, coughing, bending or strenuous activity
  • Has headaches that wake him or her up in the middle of the night
  • Misses school
  • Has any other symptoms or signs listed in this document.

IMPORTANT
Children and adolescents who experience headaches that progress -- that is, become more severe and/or frequent over time -- and particularly those who also have the symptoms mentioned on this page and/or have an abnormal neurological exam may have a more serious health problem. Children and adolescents fitting this description should be seen by their doctor as soon as possible.

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Last Updated: 7/23/2007

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