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Tests and diagnosis
By Mayo Clinic staffThe causes of most headaches in children can be found with a little detective work. Your doctor asks you and your child to describe the headaches in detail, to see if there's a pattern or a common trigger. The doctor also performs a physical exam and conducts a neurological exam, which checks for any problems with movement, coordination or sensation.
Blood tests, imaging scans and other evaluations are occasionally needed to pinpoint a diagnosis or to rule out other medical conditions that could be causing the headaches. These tests may include:
- Computerized tomography (CT). This imaging procedure uses a series of computer-directed X-rays that provide a cross-sectional view of your child's brain. This helps doctors diagnose tumors, infections and other possible medical problems that may be causing headaches.
- Magnetic resonance imaging (MRI). MRIs use radio waves and a powerful magnet to produce very detailed views of your brain. MRI scans help doctors diagnose tumors, strokes, aneurysms, neurological diseases and other brain abnormalities. An MRI can also be used to examine the blood vessels that supply the brain.
- Spinal tap (lumbar puncture). If your doctor suspects that an underlying condition, such as bacterial or viral meningitis, is the cause of your child's headaches, he or she may recommend a spinal tap (lumbar puncture). In this procedure, a thin needle is inserted between two vertebrae in the lower back to extract a sample of cerebrospinal fluid (CSF) for laboratory analysis.
- Psychological evaluation. Busy schedules, anxiety and high expectations are frequently associated with all types of childhood headaches. Some children benefit from working with a psychologist to learn biofeedback and relaxation therapy.
- Moe PG, et al. Neurologic and muscular disorders. In: Hay WW Jr., et al. Current Diagnosis and Treatment: Pediatrics. 19th ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=3405364. Accessed Jan. 9, 2009.
- Lewis DW. Headaches in children and adolescents. American Academy of Family Physicians. 2002;65:625.
- Cruse RP. Management of migraine headache in children. http://www.uptodate.com/home/index.html. Accessed Jan. 9, 2009.
- Cruse RP. Pathophysiology, clinical features, and diagnosis of migraine in children. http://www.uptodate.com/home/index.html. Accessed Jan. 9, 2009.
- Brazis PW, et al. Approach to the child with headache. http://www.uptodate.com/home/index.html. Accessed Jan. 9, 2009.
- Anttila P. Tension-type headache in childhood and adolescence. The Lancet Neurology. 2006;5:268.
- Treatment of migraine headache in children and adolescents. American Academy of Neurology. http://www.aan.com/professionals/practice/pdfs/Headache_Peds_Patients.pdf. Accessed Jan 13, 2009.
- Mack KJ (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 16, 2009.
- Mahoney KR (expert opinion). Food and Drug Administration, Rockville, Md. Feb. 4, 2009.
- Internal analgesic, antipyretic and antirheumatic drug products for over-the-counter human use: Tentative final monograph. Federal Register.1998;53:46204.
