Headache

Emergency Department

Information for patients, parents and carers

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Headache – PIAG 431 (106kB pdf)

Introduction

Headaches are a common symptom of children coming to the Emergency Department. Most headaches are caused by viral illnesses that cause head colds. These headaches can last a few days but then get better as the child gets better from the head cold. Some children can get headaches like tension headaches, migraines, or cluster headaches. More rarely, children can get headaches due to an underlying more serious problem.

Tension headaches

These feel like a band across the forehead because of tightness in the muscles around the head. They can last for a few days and tend to get worse as the day goes on. They don’t usually disturb sleep. They are more common in teenagers than younger children. Tension headaches can happen if a person hasn’t drunk enough water, eaten or slept enough.

Cluster headaches

These are painful, one sided headaches, which can stop people doing their regular activities in a day, and can be described as the worst pain they have ever felt. Sometimes people who get these headaches often have a watery eye on the side of the headache and a runny nose as well as a droopy (hanging) eyelid. They happen in clusters often every day for a few days then disappear. These more common in older children and adults.

Medication overuse headache

Sometimes taking pain medication, like paracetamol and ibuprofen, for headaches can lead to a dependency on them. When the painkillers are taken to treat headaches, the body responds by making more pain sensors in the head. This leads to the head being more sensitive and the headache comes back when the pain medication is stopped.

Primary stabbing headaches

These headaches are short, stabbing headaches which are very sudden and can hurt a lot. They only last a very short time between 5-30 seconds at any time of the day. Often the pain can be felt behind the ear and can be quite scary. People with migraines are more likely to have primary stabbing headaches. About 50% of people who get migraines get primary stabbing headaches. They are too short to treat, however migraine prevention medication can reduce the chance of getting them. Please ask your GP about this if you think it would benefit your child.

There is a separate information leaflet for migraine headaches.

What types of headaches are dangerous?

All headaches are unpleasant, however very few headaches are signs that there is a bigger problem than just the headache. Headaches that may indicate there is a more serious underlying problem will become worse over time and have other symptoms as well. Emergency Department Headache Information for patients, parents and carers.

Below is a list of other symptoms to look out for. Headaches with a serious underlying problem are much less common overall in children compared to adults. Remember, most headaches don’t have a serious underlying cause. The doctors and nurses are trained to ask questions about what your child is feeling and will then plan treatment accordingly.

When should your child see your doctor about a headache?

If your child experiences any of these signs below, they might need further checks by a doctor but
that doesn’t mean for certain that it is dangerous:

1. A head injury in the last 3 months.
2. Headaches that are worsening and especially on waking.
3. A high temperature (a fever) with neck stiffness or a sore neck.
4. Headaches that start quickly and suddenly.
5. Problems speaking and balancing.
6. Problems remembering things, like what was had for breakfast.
7. Other people notice changes in behaviour or personality.
8. Confusion or being muddled.
9. A headache which gets worse when coughing, sneezing or straining.
10. Lying down or bending over makes the pain get worse.
11. Redness or soreness to the eyes with a headache.
12. Repeated vomiting (throwing up) with no explanation.
13. Problems with eyesight, or double vision
14. New squints
15. Fitting or seizures
16. Not being able to move the head properly, or holding the head in a particular position.

This is a link to the HEAD SMART website for further information: http://www.headsmart.org.uk

Summary

Headaches are very common with viral illnesses like a head cold. Some children get tension headaches, or migraines. Many headaches don’t lead to a serious problem and go away by themselves. If headaches stop your child doing normal activities, then speak to a doctor.

• To reduce the chance of getting a headache it is advised that the suggestions below ar
  practiced:

1. Manage stress levels.
2. Eat a balanced diet (lots of fruit and vegetables).
3. Take part in regular exercise or sports.
4. Sleep on 2 or less pillows at night.
5. Drink enough water throughout the day.
6. Make sure to have plenty of sleep (6-13 year olds, 9-12 hours of sleep a day and 14-17
   year olds 8-10 hours of sleep a day)

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.

PIAG: 431