HEADACHE IN PEDIATRICS - INDICATIONS FOR IMAGING STUDIES

Headache is a very common and usually benign symptom in pediatric pati ents. Psychogenic headache and migraine are frequent. The classical ch aracteristics of migraine are not always identifiable in younger patie nts. Migraine equivalents, manifesting for instance as abdominal pain, can be seen. Cluster headache is exceedingly rare in children. Organi c lesions are present in a minority of children with headache but shou ld be considered in every case. Arterial hypertension should be looked for routinely. Abnormalities of the eye or maxillofacial area can cau se headache. An intracranial lesion is the most feared cause of headac he and should be looked for using computed tomography or magnetic reso nance imaging at the slightest doubt. Intracranial lesions that can ca use headache include vascular malformations, either nonruptured or res ponsible for subarachnoid hemorrhage; tumors, in particular in the pos terior fossa; and hydrocephalus. So-called benign intracranial hyperte nsion can be due to many causes; its prognosis depends on its etiology , and ocular sequelae can occur. Diagnostic investigations are not war ranted in all children with headache.