Organic Headaches

Fortunately, less than 5% of children's headaches are the result of serious disease or physical problems, such as an abscess, head trauma, tumor, blood clots, intracranial bleeding, or bacterial or viral meningitis.

Nevertheless, your physician will want to rule out organic causes. And, it is important to remember that restlessness, irritability or crying may be the only signs of head pain in very young children who cannot adequately express themselves and describe pain.

Fever.
A fever may produce a headache, which can be the result of the "flu" or a bacterial infection. A fever, headache and neurological symptoms together can also signal a central nervous system infection. But, on a rare occasion, a high fever and headache combination is the sign of meningitis or encephalitis, especially if these symptoms are accompanied by a stiff neck, weakness, seizures, lethargy, personality changes, nausea and vomiting. It is urgent that these diagnoses be made as quickly as possible, because delayed diagnosis can result in long-term, negative effects.

Head Trauma.
Most children have bumped their heads and a few may have suffered more severe head traumas or concussions. Sometimes it affects the scalp or bone without damaging the brain; in other cases, there may be no evidence of bone damage, but the brain is affected. The child will most probably have a headache and maybe initial nausea or vomiting. But if the headache continues for more than a few days and gets even worse, and definitely if there seems to be neurological changes (changes in response, level of consciousness, continued dizziness or nausea), then the child should be immediately examined by a physician.

Sinus infection, TMJ, dental problems.
Sometimes individuals attribute their headaches to a sinus infection, TMJ or dental problems. Although headaches can accompany TMJ (temporomandibular jaw syndrome), most of these are actually undiagnosed tension-types or migraines. If one has a sinus infection, symptoms include fever, yellow or green nasal discharge, as well as a headache. One of the reasons decongestants help these headaches is because they contain substances that constrict blood vessels. Blood vessel constriction is related to headache pain. Decongestants can become habit forming. Thus, if a person does not have a true sinus infection, but seems helped by decongestants, the headaches might actually be tension-type or migraine.

Tests
When organic causes are suspected, laboratory tests can diagnose them. Both a CT scan (computed tomography) or a MRI (magnetic resonance imaging scan) reveal problems within the brain. Unless a child has abnormal movements or has lost consciousness, an EEG (electroencephalogram) is usually unnecessary, and a skull x-ray will not be productive. While these tests may reveal tumors, abscesses, fractures or other organic problems, they do not diagnose a migraine or tension-type headache.