Diagnostic approach to nontraumatic headache in the healthy child with a normal neurologic examination and no signs of increased ICP

This algorithm provides likely causes of headache in previously healthy children based upon a combination of history and physical examination findings. Further testing may be warranted to confirm the leading diagnosis. Refer to UpToDate content on the emergency department approach to nontraumatic headache in children.

BP: blood pressure; CSF: cerebrospinal fluid; ICP: intracranial pressure.

* Rarely, visual refractive errors (anisometropia, myopia, and hyperopia) can cause chronic fronto-orbital headaches that progress throughout the day in children. Optical correction results in resolution in most causes. However, visual refractive errors remain a diagnosis of exclusion for chronic headaches in children; more urgent evaluation of signs or symptoms suggesting increased ICP should not be delayed while waiting for an ophthalmologic consultation.

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Diagnostic approach to nontraumatic headache in the healthy child with a normal neurologic examination and no signs of increased ICP