Headaches in childhood

Summary

The diagnosis and management of headache in children is a challenge to the clinician, covering as it does a wide range of diagnostic possibilities and enlisting a range of skills from neurosurgery and infectious disease to the psychological. The task is best undertaken, as in so many medical problems, by taking careful history and physical examination, including the past history, family history, and life circumstance of the child. After this is done, only in a minority of cases will it be necessary to request a specific special test, such as a CT scan, lumbar puncture or EEG. In those cases where doubt remains after initial careful evaluation or even after special studies have not resolved the question, careful follow up of the child over time, with re-examination as necessary, will allow definitive diagnosis and prevent the physician from missing obscure or in apparent disease.