In this section
The most common paediatric causes are: febrile illnesses, including ENT involvement, migraines and tension headaches. Meningitis, space-occupying lesions or subarachnoid haemorrhages are far less common but must be considered during any presentation.
In evaluation of any child presenting with headache a good history is paramount. Differentiation between acute and chronic (recurrent) headaches as well as between primary (benign) or secondary headaches is useful.
Consider “red flag” symptoms/signs
Tension-type Headaches (~50% incidence):
The following should prompt consideration of intracranial imaging (CT or MRI if available) and discussion with senior medical staff:
NB: May require CT prior to performing LP (discuss with consultant)
NB2: All children with a serious underlying condition are likely to have one or more objective findings on neurological examination.
Any child with a headache with one or more red flag symptom/sign
If neurosurgical intervention required
For emergency advice and paediatric or neonatal ICU transfers, call the Paediatric Infant Perinatal Emergency Retrieval (PIPER) Service: 1300 137 650.
Parent information sheet:
Migraine headache (see >> Headaches in children and teenagers)