Information for Parents of children with headaches

Headaches in children are incredibly common with up to 70% of school age children experiencing headache at least once a year. This is around 40% of 7 year olds and rises to 70% by the age of 15 years.

I will be utilising this page to discuss different types of headaches, treatments and emerging research in the field, and most importantly- I'll be ensuring that there is no "Doctor Jargon" and making it easily understandable for parents.

Red Flags in Children's Headaches

Aug 2024

Headaches are usually classified as primary and secondary.

Primary Headaches are conditions where the headache is the main problem and is not caused by something else. Examples include common headache diagnosis like migraines and tension type headache.

Secondary headaches are headaches caused by other issues, examples of possible issues include brain tumour, sinus infections, medication over use or infections causing meningitis.

Primary headaches are the most common type of headache. A lot of parents however are very concerned that the headaches their child have are secondary to issues like brain tumours.

As doctors we are trained to look for the ‘red-flag’ features in a headache history. Lots of these features can be present in primary headache disorders or in those with the less worrying causes of secondary headache.

The National Institute of Clinical Excellence (NICE) have published guidelines to help guide us as doctors when looking at suspected neurological conditions and red flag features in headaches (NG127):

Any one of the following:

headache that wakes them at night
headache that is present on awakening in the morning
headache that progressively worsens
headache triggered or aggravated by coughing, sneezing or bending down
headache with fever and features of meningism
headache associated with vomiting
headache associated with ataxia (disorders that affect co-ordination, balance and speech)
headache associated with change in conscious level or pervasive lethargy (that make the patient very sleepy or difficult to waken up)
headache occurring within 5 days of a head injury
headache associated with squint (this is a medical word for when the eyes are out of alignment) or sunsetting (the patient can’t look up).

As you can see, some of those symptoms might be present in migraine or in sinusitis.

If they are present in your child they should act as prompt for you to seek an urgent medical assessment.

It is the job of a skilled doctor to recognise these features and most importantly, to identify if your child needs an urgent review or more investigation.

I have to admire my colleagues in General Practice. GPs are constantly on the lookout for these patients whilst taking a headache history, and whilst my consultations can often exceed an hour, they are trying to do all this in just a matter of 7-10 minutes!