Clinical Case Database / Category: Patient Management

Headaches in children

Publication details

Dr Mei Chi Michi Wong MB, BChir, MRCPCH, Dr Anupam Shrivastava MB, BS, MD, FRCPCH
Foundation Years Journal, volume 8, issue 6, p.26 (123Doc Education, London, June 2014)


Headaches are common in children. In the majority of cases children suffer from the primary headaches, i.e. migraine and tension type headache. For the foundation year doctor/general practitioner presented with a child with headache, the clinical priority is to identify those with a serious underlying pathology (secondary headache). The following article illustrates two cases in which focused history and examination were paramount in eliciting red flags that suggested an underlying cause, which in turn lead to further investigations, diagnosis and treatment.

Access the Clinical Cases Database

A subscription is required to read the full article. Please subscribe using one of the options below.

Foundation Years Clinical Cases Database£29.006 months
Add to cart
Foundation Years Clinical Cases Database£39.0012 months
Add to cart


Dr Mei Chi Michi Wong MB, BChir, MRCPCH (Corresponding author)

Paediatric Registrar, Southend University Hospital NHS Foundation Trust
Prittlewell Chase, Westcliff-on-Sea, Essex, SS0 0RY, UK

Dr Anupam Shrivastava MB, BS, MD, FRCPCH

Consultant Paediatrician, Southend University Hospital NHS Foundation Trust
Prittlewell Chase, Westcliff-on-Sea, Essex, SS0 0RY, UK


1.  Abu-Arafeh I et al. Prevalence of headache and migraine in children and adolescents: a systematic review of population-based studies. Dev Med Child Neurol 2010;52(12):1088-97

2.  Wöber-Bingöl C. Epidemiology of migraine and headache in children and adolescents. Curr Pain Headache Rep 2013;17(6):341

3.  Zuckerman B, Stevenson J, Bailey V. Stomachaches and headaches in a community sample of preschool children. Pediatrics 1987 May;79(5):677-82

4.  Sillanpää M, Piekkala P, Kero P. Prevalence of headache at preschool age in an unselected child population. Cephalalgia 1991;11(5):239-42

5.  McCrea N, Howells R. Fifteen minute consultation: headache in children under 5 years of age. Arch Dis Child Educ Pract Ed 2013; 98:181-185

6.  Abu-Arafeh I, McLeod S. Serious neurological disorders in children with chronic headache. Arch Dis Child 2005;90:937–940

7.  Headache Classifiation Subcommittee of the International Headache Society. The international classifiation of headache disorders. Cephalalgia 2004; 24:1-160

8.  Lewis DW, Qureshi F. Acute headache in children and adolescents presenting to the emergency department. Headache. 2000 Mar;40(3):200-3.

9.  White CP. Evaluation of headaches. Paediatrics and Child Health 2011; 21:483-487

10.  Newton RW. Childhood headache. Arch Dis Child Educ Prac Ed 2008; 93:105-111

11.  Rossi LN, Vajani S, Cortinovis I, et al. Analysis of the International Classifiation of Headache Disorders for diagnosis of migraine and tension-type headache in children. Dev Med Child Neurol. 2008;50(4):305-10

12.  The diagnosis of brain tumour in children. Headsmart quick reference guide: Version 3 March 2011

13.  Nappi G, Jensen R, Nappi RE, et al. Diaries and Calendars for Migraine. A Review. Cephalalgia 2006; 26:905–16

14.  Lissauer T, Clayden G (2007) Illustrated Testbook of Paediatrics. Elsevier Limited

15.  Howard L, Wessely S, Leese M, et al. Are investigations anxiolytic or anxiogenic? A randomised controlled trial of neuroimaging to provide reassurance in chronic daily headache. J Neurol Neurosurg Psychiatry. 2005;76(11):1558-64

16.  McShane MA, Hughes SJ. Managing headache in children. Paediatrics and Child Health 2011; 21(11):518-520

17.  Abu-Arafeh I. Headache in children and adolescents. Paediatrics and Child Health 2007; 18(1):42-43

18.  Russell MB, Lundqvist C. Prevention and management of medication overuse headache. Curr Opin Neurol. 2012 Jun;25(3):290-5

19.  The HeadSmart campaign.

20.  Friedman DI, Li GT, Digre KB. Revised Diagnostic Criteria for the pseudomotorcerebri syndrome in adults and children. Neurology 2013; 81:1159-1165

21.  Babiker MOE, Prasad M, MacLeod S, et al. Fifteen-minute consultation: the child with idiopathic intracranial hypertension. Arch Dis Child Educ Prac Ed 2014; 0:1-7


Conflict Of Interest

The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (

Financial Statement

The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.

Patient Consent statement

All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts ( The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.

Animal & Human Rights

When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.

About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.