Headache

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
Migraine headaches: Recurrent severe, incapacitating headaches
Other common causes: Hunger, exertion, sunlight
Serious causes: Meningitis or encephalitis

See More Appropriate Topic (instead of this one) If

Followed a head injury within last 3 days, see HEAD INJURY
Pain is around the eye or the cheekbone, see SINUS PAIN AND CONGESTION

WHEN TO CALL YOUR DOCTOR

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 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

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

You think your child needs to be seen
Fever
Sinus pain (not just congestion)

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 ongoing problem

Parent Care at Home If

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

HOME CARE ADVICE FOR HEADACHES

Treatment for Mild Headache

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.
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).
Rest: Lie down in a quiet place and relax until feeling better.
Local Cold: Apply a cold wet washcloth or cold pack to the forehead for 20 minutes.
Stretching: Stretch and massage any tight neck muscles.
Call Your Doctor If:
- Headache becomes severe
- Isolated headache lasts over 24 hours
- Headache lasts over 3 days despite using a pain medicine
- Your child becomes worse

Treatment for Migraine Headache

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

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 7/15/2007

Last Revised: 8/7/2007

Content Set: Pediatric HouseCalls Online