Headaches in kids: when to worry.
What's common at each age, the red flags that need prompt care, and when a neurologist should take a look.
Most childhood headaches are ordinary. A few patterns should not wait.
Headaches are genuinely common in children, most school-age kids and teens get them, and the usual culprits are mundane: not enough sleep, skipped meals, dehydration, screen strain, stress, or a virus. Migraine also runs in families and often shows up in childhood, sometimes as head pain with nausea and light sensitivity, sometimes in younger kids mainly as stomach upset and pallor.
Most headaches are not dangerous, but some patterns should never wait: a sudden 'worst ever' headache; headache with fever and a stiff neck; headache that wakes a child from sleep or is worst in the morning with vomiting; headache after a head injury; or any headache with weakness, vision changes, confusion, or trouble walking. Those need prompt medical care, urgent care or the ER depending on severity.
Recurring headaches that disrupt school, headaches that are getting more frequent, or any headache pattern that's changing deserve a neurological evaluation. Dr. Sedgh trained in both pediatrics and neurology and evaluates headaches from early childhood through age 18. If your child's headaches are becoming a pattern, you can request an in-person evaluation.
A few notes that make the visit useful
Headache diaries do not need to be fancy. Age, time of day, and what else happened are enough.
- How often they come, and how long they last
- Whether they wake your child from sleep
- Nausea, light sensitivity, or a change in vision or balance
- Medicines already tried, without needing doses listed here
Seek urgent care for a sudden worst-ever headache, a headache with a seizure, repeated vomiting, a child who is hard to wake, or weakness, confusion, or a fever with a stiff neck. Those are not "wait for the clinic" problems.
Patterns worth separating
Time of day
Headaches that wake a child from sleep are a different flag from headaches after a long school day.
What comes with them
Vision change, balance trouble, vomiting, or a seizure beside the pain changes the urgency.
How often
A rare headache and a headache most weeks are not planned the same way.
Whether a scan helps
Imaging is for red flags in the story or the exam, not a default because a child has pain.
What to expect.
Urgent signs go to urgent care
Worst-ever, seizure, hard to wake, repeated vomiting, weakness, or fever with a stiff neck.
A short diary
Age, timing, length, and what else you noticed. A week of notes is enough to start.
Exam, then a decision
The neurological exam decides whether watching, treatment discussion, or a scan is the honest next step.
Imaging is a decision, not a habit
Many children with headaches do not need a scan. A scan is considered when the history or the exam has a red flag, not because headaches are frightening. Dr. Sedgh will say if a scan would change anything, and if it would not.
The pattern still depends on age. A preschooler who holds their head is a different story from a teenager with a familiar migraine. Read how headaches in children are described for parents.
Frequently asked questions
What should I record?
The visit starts with the pattern: when headaches hit, how long they last, what makes them better or worse, and how they're affecting school and sleep. A headache diary from home is genuinely helpful. The neurological exam screens for the uncommon but serious causes, and Dr. Sedgh will tell you plainly whether imaging is actually needed, often it isn't.
Will I be quoted a scan price here?
Cost depends on insurance and on whether any testing is recommended, which for most childhood headaches it is not. The practice can discuss fees with you directly when you request a visit.
Do we need more than one visit?
An initial evaluation typically takes one visit. Because headache patterns reveal themselves over weeks, a short follow-up to review a headache diary is often part of the plan, and red-flag symptoms are always triaged more urgently.
Does every child with headaches need an MRI?
No. Many childhood headaches are evaluated with a history and an exam alone. A scan is considered when something in the story or the exam is a warning sign, not because the headache is scary.
Which headaches should not wait for a clinic appointment?
A sudden worst headache, a headache with a seizure, repeated vomiting, trouble waking, new weakness or confusion, or fever with a stiff neck should be treated as urgent.