OHSU

Headache

DEFINITION

  • Pain or discomfort of the scalp or forehead areas
  • The face and ears are excluded

Causes

  • Viral illnesses: Most headaches are part of a viral illness, especially with colds. These usually last a few days.
  • Muscle tension headaches: Most common type of recurrent headaches
  • Migraine headaches: Recurrent severe, incapacitating headaches
  • Other common causes: Hunger, exertion, sunlight, coughing
  • Serious causes: Meningitis or encephalitis

See More Appropriate Topic (instead of this one) If

WHEN TO CALL YOUR DOCTOR

Call 911 Now (your child may need an ambulance) If

  • Difficult to awaken or passed out
  • Confused thinking/talking or slurred speech
  • Blurred or double vision
  • Weakness of arm or leg or unsteady walking

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Stiff neck (can't touch chin to chest)
  • Severe headache
  • Vomiting
  • You think your child needs to be seen urgently

Call Your Within 24 Hours (between 9am and 4pm) If

  • You think your child needs to be seen, but not urgently
  • Fever
  • Sinus pain (not just congestion)

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns Headache without other symptoms present over 24 hours
  • Sore throat present over 48 hours
  • Any headache present over 3 days
  • Headaches are a recurrent chronic problem

Patient Home Care If

  • Mild headache and you don't think your child needs to be seen

HOME CARE ADVICE FOR HEADACHES

Treatment for Mild Headache

Reassurance:

  • Headaches are very common with viral illness, especially with colds. They usually resolve in 2 or 3 days.
  • Unexplained headaches can occur in children, just as they do in adults. They usually pass in a few hours or last up to a day.
  • Most headaches (including muscle tension headaches) are helped by the following measures. 

Pain Medicine:

Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief (see Dosage table). Headaches due to fever are also helped by fever reduction.

Food: Give fruit juice or food if your child is hungry or hasn't eaten in more than 4 hours (Reason: Skipping a meal can cause a headache in many children).

Rest: Lie down in a quiet place and relax until feeling better.

Local Cold: Apply a cold wet washcloth or cold pack to the forehead for 20 minutes.

Stretching: Stretch and massage any tight neck muscles.

Call Your Doctor If:

  • Headache becomes severe
  • Vomiting occurs
  • Isolated headache lasts over 24 hours
  • Headache lasts over 3 days
  • Your child becomes worse

Extra Advice - Muscle Tension Headache Prevention:

  • If something is bothering your child, help him talk about it and get it off his mind.
  • Teach your child to take breaks from activities that require sustained concentration. Encourage your child to do relaxation exercises during the breaks.
  • Teach your child the importance of getting adequate sleep.
  • If over-achievement causes headaches, help your child find more balance.
  • Caution: Your child should have a complete medical checkup before you conclude that recurrent headaches are due to worrying too much or stress.

Treatment for Migraine Headache

Reassurance: This headache is similar to previous migraine headaches that your child has experienced.

Migraine Medication:

  • If your child's doctor has prescribed a specific medication for migraine, give it as directed as soon as the migraine starts.
  • If not, ibuprofen is the best over-the-counter drug for migraine. Give ibuprofen now and repeat in 6 hours if needed (See Dosage Table).

Sleep: Have your child lie down in a dark, quiet place and try to fall asleep. People with migraine often awaken from sleep with their migraine gone.

Prevention of Migraine Attacks:

  • Stay well hydrated.
  • Don't skip meals.
  • Get adequate sleep each night.

Call Your Doctor If:

  • Headache becomes much worse than usual
  • Headache lasts longer than usual


Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

 

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Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 9/15/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.

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