WHEN TO IMAGE IN HEADACHE

migraine is common in children with family history of migraine. you may see a child tension headche. you may have no pointers for a tumor when you see a child

Migraine

INDICATIONS FOR NEUROIMAGING IN A CHILD WITH HEADACHES

Abnormal neurologic examination

Abnormal or focal neurologic signs or symptoms

	•	Focal neurologic symptoms or signs developing during a headache (i.e., complicated migraine)
	•	Focal neurologic symptoms or signs (except classic visual symptoms of migraine) develop during the aura, with fixed laterality; focal signs of the aura persisting or recurring in the headache phase

Seizures or very brief auras (<5 min)

Unusual headaches in children

	•	Atypical auras including basilar-type, hemiplegic
	•	Trigeminal autonomic cephalalgia including cluster headaches in child or adolescent
	•	An acute secondary headache (i.e., headache with known underlying illness or insult)

Headache in children <6 yr old or any child that cannot adequately describe their headache

Brief cough headache in a child or adolescent

Headache worst on first awakening or that awakens the child from sleep

Migrainous headache in the child with no family history of migraine or its equivalent

About Dr. Jayaprakash