Summary
Differentials
Common
- Migraine headache
- Acute sinusitis
Uncommon
- Subarachnoid hemorrhage
- Ischemic stroke
- Parenchymal hemorrhage
- Vascular dissection (carotid, vertebral, or intracranial arteries)
- Cerebral sinovenous thrombosis
- Postconcussion headache
- Cerebral contusion
- Subdural hemorrhage
- Intracranial hypotension
- Epidural hemorrhage
- Meningitis
- Encephalitis
- Dental caries, gingival disease, or abscess
- Brain tumor
- Temporomandibular disorders
- Tension headache
- Indomethacin-responsive headache
- Medication overuse headache
- Cluster headache
- New daily persistent headache
- Intermittent hydrocephalus
- Pseudotumor cerebri (idiopathic intracranial hypertension)
- Ventriculoperitoneal shunt dysfunction
- Pituitary apoplexy
- Hypertensive encephalopathy
- Occipital neuralgia
- Facial neuralgia
Contributors
Authors
Christopher B. Oakley, MD
Assistant Professor
Department of Child Neurology
Johns Hopkins Hospital
Baltimore
MD
Disclosures
CBO declares that he has no competing interests.
Acknowledgements
Dr Christopher B. Oakley would like to gratefully acknowledge Dr Nicholas S. Abend and Dr Daniel J. Licht, the previous contributors to this topic.
Disclosures
NSA and DJL declare that they have no competing interests.
Peer reviewers
Paul Hamilton, MD
Director
Department of Emergency Medicine
Mount Sinai School of Medicine
New York
NY
Disclosures
PH declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211.Full text Abstract
American College of Radiology. ACR Appropriateness Criteria®: headache-child. 2017 [internet publication].Full text Abstract
National Institute for Health and Care Excellence. Headaches in over 12s: diagnosis and management. Jun 2025 [internet publication].Full text
Lewis DW, Ashwal S, Dahl G, et al. Practice parameter: evaluation of children and adolescents with recurrent headaches: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2002 Aug 27;59(4):490-8.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Patient information
Middle ear infection
Migraine in children
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