Diagnosing Headache in Young People

  • Çiçek Wöber-Bingöl
  • Andrew D. Hershey
  • Marielle A. Kabbouche
Reference work entry


Headache is the most common somatic complaint in children and adolescents. Diagnosis is based on thorough history with the patient and the caregiver. History is the prerequisite for differentiating primary from secondary headaches and for recognizing potentially life-threatening disorders. Red flags include the first or worst headache ever in the life, recent headache onset, increasing severity or frequency, occipital location, awakening from sleep because of headache, headache occurring exclusively in the morning associated with severe vomiting, and headache associated with straining. History must cover all features required for headache diagnosis according to the International Classification of Headache Disorders (ICHD) as well as general medical problems, especially possible comorbid disorders, family history, social background, life events, lifestyle, as well as factors precipitating and alleviating headache. History has to be completed by detailed general and neurological examinations. The question whether imaging, laboratory tests, or other investigations are required is based on the clinical findings, i.e., history and clinical examination. In patients with recurrent or chronic headache, a headache diary is recommended particularly for differentiating migraine from tension-type headache and for assessing use and efficacy of abortive medication. A thorough evaluation of recurrent headache in children and adolescents is necessary to make a specific diagnosis and initiate treatment, bearing in mind that children with headache are more likely to experience psychosocial adversity and to grow up with an excess of both headache and other physical and psychiatric symptoms, thus creating an important healthcare problem for their future life.


Cluster Headache Chronic Migraine Migraine With Aura Chronic Headache Migraine Without Aura 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Lifting The Burden 2011

Authors and Affiliations

  • Çiçek Wöber-Bingöl
    • 1
  • Andrew D. Hershey
    • 2
  • Marielle A. Kabbouche
    • 2
  1. 1.Department of Child and Adolescent PsychiatryMedical University of ViennaViennaAustria
  2. 2.Division of Neurology, Department of Pediatrics, Headache CenterCincinnati Children’s Hospital Medical Center, University of Cincinnati College of MedicineCincinnatiUSA

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