children suffer from the same types of headaches as adults do, but their symptoms may be slightly different. The diagnostic approach to headache in children is similar to that of adults. However, young children may not be able to verbalize pain well. If a young child is fussy, he may have a headache.
In some cases, headaches in children are caused by an infection, high levels of stress or anxiety, or minor head trauma. It’s important to pay attention to your child’s headache symptoms and consult a doctor if the headache worsens or occurs frequently. Headaches in children usually can be treated with over-the-counter pain medications and other lifestyle measures.
Causes of Headaches
Headaches are thought to be caused by changes in chemicals, nerves, or blood vessels in the area. These changes send pain messages to the brain and bring on a headache.
In general, kids get the same types of headaches as adults. And headaches often are hereditary, so if a parent gets them, their kids might too.
Some of the many potential headache triggers include:
- certain medications (headaches are a potential side effect of some)
- too little sleep or sudden changes in sleep patterns
- skipping meals
- becoming dehydrated
- being under a lot of stress
- having a minor head injury
- using the computer or watching TV for a long time
- vision problems
- experiencing changes in hormone levels
- taking a long trip in a car or bus
- listening to really loud music
- smelling strong odors such as perfume, smoke, fumes, or a new car or carpet
- drinking or eating too much caffeine (in soda, coffee, tea, and chocolate)
- consuming certain foods (such as alcohol, cheese, nuts, pizza, chocolate, ice cream, fatty or fried food, lunchmeats, hot dogs, yogurt, aspartame, or anything with the food additive MSG)
In some cases, headaches are caused by certain infections, such as:
- ear infections
- viral infections, like the flu or common cold
- strep throat
- sinus infections
- Lyme disease
Most headaches aren’t signs that something more is wrong, but occasionally headaches are caused by more serious medical conditions.
Just as in adults, most headaches are benign, but when head pain is accompanied with other symptoms such as speech problems, muscle weakness, and loss of vision, a more serious underlying cause may exist:hydrocephalus, meningitis, encephalitis, abscess, hemorrhage, tumor, blood clots, or head trauma. In these cases, the headache evaluation may include CT scan or MRI in order to look for possible structural disorders of the central nervous system. If a child with a recurrent headache has a normal physical exam, neuroimaging is not recommended. Guidelines state children with abnormal neurologic exams, confusion, seizures and recent onset of worst headache of life, change in headache type or anything suggesting neurologic problems should receive neuroimaging.
In general, though, certain symptoms tend to fall more frequently under certain categories.
Migraines can cause:
- Pulsating, throbbing or pounding head pain
- Pain that worsens with exertion
- Abdominal pain
- Extreme sensitivity to light and sound
Even infants can have migraines. A child who’s too young to tell you what’s wrong may cry and hold his or her head to indicate severe pain.
Tension-type headaches can cause:
- A pressing tightness in the muscles of the head or neck
- Mild to moderate, nonpulsating pain on both sides of the head
- Pain that’s not worsened by physical activity
- Headache that’s not accompanied by nausea or vomiting, as is often the case with migraine
Younger children may withdraw from regular play and want to sleep more. Tension-type headaches can last from 30 minutes to several days.
Cluster headaches are uncommon in children under 12 years of age. They usually:
- Occur in groups of five or more episodes, ranging from one headache every other day to eight a day
- Involve sharp, stabbing pain on one side of the head that lasts from 15 minutes to three hours
- Are accompanied by teariness, congestion, runny nose, or restlessness or agitation
Chronic daily headache
Doctors use the phrase “chronic daily headache” (CDH) for migraine headaches and tension-type headaches that occur more than 15 days a month for more than three months. CDH may be caused by an infection, minor head injury or taking pain medications — even nonprescription pain medications — too often.
When children complain of headaches, many parents are concerned about a brain tumor. Generally, headaches caused by brain masses are incapacitating and accompanied by vomiting. One study found characteristics associated with brain tumor in children are: headache for greater than 6 months, headache related to sleep, vomiting, confusion, no visual symptoms, no family history of migraine and abnormal neurologic exam.
Some measures can help prevent headaches in children. Drinking plenty of water throughout the day, avoiding caffeine, getting enough and regular sleep, eating balanced meals at the proper times, and reducing stress and excess of activities may prevent headaches. Treatments for children are similar to those for adults, however certain medications such as narcotics should not be given to children.
Children who have headaches will not necessarily have headaches as adults. In one study of 100 children with headache, eight years later 44% of those with tension headache and 28% of those with migraines were headache free. In another study of people with chronic daily headache, 75% did not have chronic daily headaches two years later, and 88% did not have chronic daily headaches eight years later.