headACHES

Headaches in children, though less common than in adults, can signal significant health issues, although most of the time they turn out to be harmless. Pay attention to recurring headaches or those accompanied by symptoms such as vomiting, poor coordination, or neurological changes, and seek prompt medical attention at our office in such cases. Keeping a headache diary, detailing the frequency, duration, and severity, can aid in diagnosis and management. For mild and infrequent headaches, acetaminophen is typically effective; refer to the Dosing Guide for the correct dosage.

Certain types of headaches require immediate medical attention. If a headache is accompanied by fever and a stiff neck, it may indicate meningitis, a serious condition that needs urgent medical evaluation. Headaches following head trauma should also be taken seriously; refer to the sections on head injury and concussion in this handbook for further guidance. In particular in those cases, vomiting more than three times after head trauma is particularly concerning, as it may indicate brain bleeding. In such cases, seek emergency medical care at the ACH ER or call 911, as an urgent CT scan may be necessary to determine if neurosurgical intervention is necessary.

Chronic recurring headaches, such as migraines, tension headaches, or sinus headaches, can be distressing for children and should be evaluated during regular office hours. Migraines, often hereditary, present with symptoms such as throbbing pain, nausea, vomiting, and sensitivity to light, and they usually improve with sleep. Fortunately, treatments are available to prevent and reduce the frequency of these headaches. Recurring headaches should be evaluated by a physician.

A headache that awakens a child from sleep should be considered potentially serious and requires an office visit. Other concerning headache symptoms include moderate to severe pain, especially if it originates behind the eyes and worsens with eye movements, tinnitus (ringing in the ears), nausea and vomiting, vision changes (such as blurring, decreased vision, double vision, or seeing light flashes), and dizziness. Any of these symptoms should prompt a timely evaluation to ensure appropriate management and to rule out any underlying health issues.