Headaches in children

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Tests and diagnosis

By Mayo Clinic staff

To learn about the nature of your child's headache, your doctor will likely recommend the following steps:

  • Headache history. Your doctor asks you and your child to describe the headaches in detail, to see if there's a pattern or a common trigger. Your doctor may also ask you to keep a headache diary for a time, so you can record more details about your child's headaches, such as frequency, severity of pain and possible triggers.
  • Physical exam. The doctor also performs a physical exam, including measuring your child's height, weight, head circumference, blood pressure and pulse, and examining your child's eyes, neck, head, shoulders and spine.
  • Neurological exam. Your doctor checks for any problems with movement, coordination or sensation.

If your child is otherwise healthy and headache is the only symptom, no further testing usually is needed. In a few cases, however, imaging scans and other evaluations are needed to pinpoint a diagnosis or to rule out other medical conditions that could be causing the headaches. These tests may include:

  • Computerized tomography (CT). This imaging procedure uses a series of computer-directed X-rays that provide a cross-sectional view of your child's brain. This helps doctors diagnose tumors, infections and other possible medical problems that may be causing headaches.
  • Magnetic resonance imaging (MRI). MRIs use radio waves and a powerful magnet to produce very detailed views of the brain. MRI scans help doctors diagnose tumors, strokes, aneurysms, neurological diseases and other brain abnormalities. An MRI can also be used to examine the blood vessels that supply the brain.
  • Spinal tap (lumbar puncture). If your doctor suspects that an underlying condition, such as bacterial or viral meningitis, is the cause of your child's headaches, he or she may recommend a spinal tap (lumbar puncture). In this procedure, a thin needle is inserted between two vertebrae in the lower back to extract a sample of cerebrospinal fluid (CSF) for laboratory analysis.
Treatments and drugs Preparing for your appointment
References
  1. Bronthius DJ, et al. Approach to the child with headache. http://www.uptodate.com/home/index.html. Accessed Jan. 3, 2011.
  2. Cummings E, et al. Evaluation and management of headache in the pediatric patient. Emergency Medicine. 2009;41:36.
  3. Abu-Arafeh I, et al. Prevalence of headache and migraine in children and adolescents: A systematic review of population-based studies. Developmental Medicine & Child Neurology. 2010;52:1088.
  4. Cruse RP. Management of migraine headache in children. http://www.uptodate.com/home/index.html. Accessed Jan. 3, 2011.
  5. Cruse RP. Pathophysiology, clinical features, and diagnosis of migraine in children. http://www.uptodate.com/home/index.html. Accessed Jan. 3, 2011.
  6. Monteith TS, et al. Tension type headache in adolescence and childhood: Where are we now? Current Pain and Headache Reports. 2010;14:424.
  7. Cruse RP. Tension-type headache in children. http://www.uptodate.com/home/index.html. Accessed Jan. 3, 2011.
  8. Lewis D, et al. Practice parameter: Pharmacological treatment of migraine headache in children and adolescents: Report of the American Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society. Neurology. 2004;63:2215.
  9. Lewis D, et al. Practice parameter: Evaluation of children and adolescents with recurrent headaches: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2002;59:490.
  10. Headaches in children. American Headache Society. http://www.achenet.org/education/patients/HeadachesinChildren.asp. Accessed Jan. 4, 2011.
  11. Anttila P. Tension-type headache in childhood and adolescence. The Lancet Neurology. 2006;5:268.
  12. Mahoney KR (expert opinion). Food and Drug Administration, Rockville, Md. Jan. 10, 2011
  13. Internal analgesic, antipyretic and antirheumatic drug products for over-the-counter human use: Tentative final monograph. Federal Register.1988;53:46204.
  14. Mack KJ. An approach to children with chronic daily headache. Developmental Medicine & Child Neurology. 2006;48:997.
DS01132 March 3, 2011

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