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Headache

What is a headache?

A headache is a pain in any area of the head. Headaches are more common in teens or older children. Young children may have them too.

Most headaches are not a sign of a more serious illness.

Signs and symptoms of headache

A headache feels like a sharp pain, throbbing sensation, or a dull ache. The pain may occur on one or both sides of the head. Your child may feel the pain only in one area of the head.

Ask your child about any associated symptoms, such as:

    • changes in concentration, memory, or speech
    • weakness of an arm or leg
    • any vision or hearing changes
    • fever
    • congestion
    • nausea or vomiting (throwing up)

    Make note of possible triggers relating to the headaches, such as:

    • lack of sleep
    • diet
    • using video games, watching TV or flashing lights
    • any history of head injury or concussions

Causes of headache

Headaches can be primary or secondary. Primary headaches relate to changes in brain chemicals, nerve or blood vessel function, or muscle tension in the area of the head or neck.

A secondary headache is caused by another medical condition that your child already has. These include:

  • minor or major infections
  • allergies
  • effects of medications
  • stress or anxiety
  • sensitivities to certain foods or ingredients
  • head injury
  • sinus irritation
  • dental or TMJ (temporomandibular joint) sources
  • exposure to drugs or toxins
  • brain problems such as aneurysms or tumours
  • many other causes

Your child’s headache is most likely a symptom caused by one of the following:

  • a cold, flu​ or viral illness
  • toothache or other dental problem
  • overtiredness
  • hunger

Your child's doctor can find out the cause of the headache by completing a medical history and physical assessment with your child. in rare cases, the headache could mean your child has a more serious condition. 

Call your child's doctor if your child has:

  • a sudden, severe pain in the head
  • a headache accompanied by symptoms such as dizziness, stiff neck, vomiting or nausea, confusion, slurred or altered speech, loss of or double vision, or weakness of a part of the body

If your child's headaches are waking your child from sleep or disrupting favourite activities, a doctor should examine your child.

Types of headaches

Tension headaches

If your child complains of a chronic or recurrent (repeating) headache, he may have tension headaches. This is the most common type of headache in children. A tension headache feels like there is a tight band around the head. The neck muscles may also be tender and tight.

Tension headaches can be caused by using computers, video games, or other machines for a long time or without breaks. Your child may have a tension headache because because he is feeling anxious about conflict with parents, teachers, or friends. A change in your child's usual activities, or routines can also cause tension headaches.

Migraines

Children can suffer from migraine headaches. These begin in adolescence, but sometimes young children can be affected. Children who develop migraines are likely to have one or more relatives with migraines. They may have suffered from stomach pain that comes back and again and again or unexplained vomiting when they were younger.  

Migraine headaches are usually recurrent. This means they come back again and agin. Your child may have other symptoms before the headache starts. He may feel pain only in one area of the head, such as behind the eye. The pain may also be more generalized (all through the head).

In young women, migraine headaches may be related to the monthly menstrual cycle.

Migraine headaches can be made worse by looking at bright lights or listening to loud sounds. They often improve in darker and quieter settings. Your child may have nausesa and vomiting.  

Cluster headaches

Cluster headaches are the most painful types of headaches. Cluster headaches are severe headaches that happen often over a certain number of days or weeks. There is a time period of no headaches in between clusters. Most people have 2 cluster periods per year, but each person has their own pattern. For example, you may have many clusters per year, or there could be many years between clusters.

Cluster headaches are rare. They are not associated with a more serious condition.

Taking care of your child with a headache at home

Your child may have a headache because he feels hungry. Offer your child some food to eat. A nap or resting in a calm and peaceful setting may also help your child feel better.

If the headache is very strong, you can offer your child pain medications such as acetaminophen (Tylenol®, Tempra, or other brands) or ibuprofen (Motrin®, Advil®, or other brands). If your child has been diagnosed with migraine or recurrent headaches, give pain relief as soon as your child feels the headache coming on. This will help stop the headache early.

Before going to the doctor  

If your child complains of repeated or recurring headaches, take him to the doctor.

Before the appointment, take notes on the details of the headache, such as:

  • the type of pain
  • the location of the pain (where it is)
  • how long the pain lasts (minutes or hours)
  • the time of day when your child feels the pain (morning, afternoon, or evening)
  • the outside factors when he feels the pain (is there a bright light? Is it during a certain class at school?)
  • any treatment that helps lessen the pain

If your child has recurrent headaches, record the timing of the headaches in a "headache diary." This helps the doctor find a pattern.

When to see a doctor

Make an appointment with your child’s regular doctor if:

  • headaches isolated to one area of the head last longer than 2 days
  • headaches do not improve, or get worse, despite using acetaminophen or ibuprofen or other headache remedies
  • headaches affect your child’s usual habits or routines such as play, school, eating, drinking, or sleeping
  • recurrent headaches happen more often or are worse than usual
  • recurrent headaches are not improving with recommended treatments and medications
  • the headaches are waking your child at night, and are associated with vomiting

Go to your nearest Emergency Department or call 911 if your child has a headache with the following symptoms:

  • sudden severe pain in the head
  • a headache that gets worse or continues to come back following a head injury
  • dizziness, fainting, loss of consciousness
  • high fever
  • stiff neck
  • nausea or vomiting (throwing up)
  • slurred or altered speech
  • loss or weakness of a part of the body
  • difficulty sleeping

Key points

  • Headaches in children are uncomfortable and may cause you to worry. They are rarely associated with a more serious medical condition.
  • Care for simple headaches by making your child feel comfortable. Give over-the-counter medications like acetaminophen or ibuprofen​.
  • A doctor does a medical assessment to help identify the cause of a recurrent or persistent headache.
  • Your child should have an immediate assessment in the clinic or emergency department if he has sudden onset and severe headaches. 

Tonya Solano, MD

Janine A. Flanagan, HBArtsSc, MD, FRCPC

3/5/2010




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