A headache can be serious if:
child has persistent headache without any obvious cause or following a head injury.
headache is associated with persistent vomiting, squinting, loss of balance or disturbed consciousness.
headache is followed by convulsions or by loss of consciousness.
headache is severe at onset.
child has headaches whose character and frequency have changed.
SYMPTOMS: While the older
child will be able to tell you he has a headache, smaller ones may be fretful or bang
their heads persistently. However, occasional banging of the
head in a toddler is often behaviour-related.
Viral or bacterial infections can cause a headache.
Usually, the child also has fever and body ache. Paracetamol relieves
this type of headache for a couple of hours till the child
recovers from the infection. The child is otherwise alert. He may
be an obvious case of a viral cold with running nose or a
bacterial infection like acute tonsillitis.
Psychogenic Factors And Fatigue
School going children under undue stress, sleep
deprivation and emotional disturbances can have frequent headaches.
A child complaining of headache towards the end of the
day may need his eyes to be checked.
In persistent infection of the sinuses (hollows present
in our bones nearer the nose), the headache is typically
noticed on waking up.
Repetitive stereotype headaches are usually not due to serious causes like a brain
tumour. One such example of
a relatively benign condition is migraine.
If there is a family history of migraine, this condition
should especially be considered. While adults often have a
headache that affects one half of the head, children may complain
of a generalised headache in migraine. A few precipitating
factors are stress, bright sunlight, cheese, chocolates, chilled
food, cold drinks, ice cream and nuts. The attacks of headache are often associated with nausea or vomiting. The child is
perfectly all right between attacks.
Migraine aura (which precedes an attack of migraine) without headache has also
been found in some children. In this condition, the child has
distortion of visual image, frequently consisting of things looking smaller than they are (micropsia), or
seeing bright lights, or the appearance of distortion of body image (the Alice in
Wonderland Syndrome). A positive personal history or family history of classical
migraine in such cases may clinch the diagnosis.
A persistent headache following a history of head injury should not be ignored. Most vomiting
after mild head
injury is said to be related to migraine, but a persistent
headache or vomiting could be related directly to the head injury.
Fever, a fixed gaze, or disturbed consciousness should
raise the possibility of a diagnosis of meningitis.
A small infant may have a bulging anterior fontanelle
(the soft spot on the head). Neck stiffness is present in
most cases of meningitis.
A persistent headache, lasting day and night, could be due to a brain
persistent vomiting, squint, loss of balance, convulsions and
disturbed consciousness add to the suspicion of a brain tumour or
any other space-occupying lesion in the brain.
Headaches due to migraine may be preceded by blurring of vision followed by vomiting. This
should not be
construed as suggestive of a brain tumour.
High Blood Pressure
This is a rare cause of headache.
TREATMENT: In routine
cases, take the child in your lap and press his head gently. If he does not object, apply
a little balm on his temples. Paracetamol may also be given. Ibuprofen has been found to be more effective than
paracetamol in headaches due to migraine.
Attend to any emotional factors. Make sure he has food
at regular intervals, Hunger can add to the problem. Check
his hours of sleep. Exercise has been found to help fight
migraine by improving blood flow to the brain, by boosting blood
levels of brain chemicals that suppress pain, and by conferring
a general feeling of relaxation and well-being. However,
sudden and vigorous exercise should be avoided. It may actually trigger or aggravate an attack.
For temporary headaches associated with fever, paracetamol and treatment of the infection
with suitable drugs, if required, should be enough.
For a persistent complaint, specially associated with
other worrying symptoms mentioned earlier, take your child to
the doctor soon so that the proper diagnosis can be made at
an early stage.
11 February, 2013