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When to Worry

When to Worry About Your Child’s Headaches

Fortunately, less than 2% of pediatric and adolescent headaches are the result of a serious disease or physical problem.

When should a more serious problem be considered?


Medical History

A more serious problem should be considered when your child’s general medical or neurological history reveal any of the following:

  • New headaches that have been occurring for less than 6 months, are worsening and do not improve after treatment
  • Progressive headaches: headaches that are becoming more severe and frequent over time
  • No family history of similar headaches
  • A family history of neurological disease
Physical Exam

A more serious problem should be considered when your child’s physical exam reveals any of the following:

  • Abnormalities of temperature, breathing, pulse or blood pressure
  • Inflammation of the optic nerve, the nerve in the back of the eye
  • An enlarged head
  • A noise or bruit in the head heard through a stethoscope
  • Coffee-colored spots on the skin
Neurological Symptoms

A more serious problem should be considered when your child has any of these neurological symptoms:

  • Nausea or vomiting
  • Weakness
  • Dizziness
  • Sudden loss of balance or falling
  • Numbness or tingling
  • Paralysis
  • Speech difficulties
  • Mental confusion
  • Seizures
  • Loss of consciousness
  • Personality changes/inappropriate behavior
  • Vision changes (blurry vision, double vision or blind spots)
  • Lethargy: being indifferent, apathetic or sluggish, or sleeping too much

A structural disorder of the central nervous system, as listed below, may be suspected in the development of serious headaches:

  • Tumor
  • Abscess
  • Hemorrhage (bleeding within the brain)
  • Bacterial or viral meningitis (an infection or inflammation of the membrane that covers the brain and spinal cord)
  • Pseudotumor cerebri (increased intracranial pressure)
  • Hydrocephalus (abnormal build-up of fluid in the brain)
  • Infection of the brain
  • Encephalitis (inflammation of the brain)
  • Blood clots
  • Head trauma