Headache in children

Question 1

Warning signs

Answer 1

very severe 
wakes child from sleep or worse upon waking up then gets better 
chronic progressive 
increasing frequency and severity 
worsened by coughing and sneezing 
change in personality 
history of convulsions 
relieved by effortless vomiting 
neurological deficit 
signs of meningeal irritation

Question 2

Special investigations

Answer 2

always as per indication 
sinus x-rays 
LP - if acute and meningitis 
Neuro-imaging 
- CT for intra-cranial bleeds 
- CT/MRI if warning signs are present 
       recent onset severe headache 
       change in type of headache 
       neurological dysfunction 
              focal finding 
              signs of raised ICP 
              change in LOC 
              seizures