Managing headache in the pediatric emergency department

Headache is a common complaint in children and adolescents. While the majority of headaches are self-limited and benign, headaches occasionally herald a life-threatening illness such as a brain tumor, intracranial hemorrhage, or meningitis. The emergency department physician has to distinguish between “benign” and “serious” headaches and therefore must have a rational, organized approach to the evaluation of these patients. This article will focus on a clinical classification system for childhood and adolescent headaches and discuss their emergency department evaluation and current recommended therapy.