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Pediatric Practice: Infectious DiseasePediatric Practice: Infectious Disease

Section 2. Signs and Symptoms > 

Chapter 10. Headache

Robert A. Avery
Topics Discussed: headache; migraine disorders; neurology.
Sections: Differential Diagnosis, History and Physical Examination, Laboratory Studies, Evaluation, Indications for Consultation or Referral, References.
Excerpt:"Headache is defined as pain located at any part of the head, but not necessarily in a specific nerve distribution. Headaches can be primary or secondary. Primary headaches cannot be attributed to another medical, systemic, or intracranial disorder. A common primary headache is migraine. The criteria for pediatric migraine include at least five attacks lasting between 1 and 72 hours, at least one associated symptom (photophobia, phonophobia, vomiting, nausea) and at least two of the following major criteria: unilateral or bilateral location (i.e., bifrontal or bitemporal as opposed to global); pulsating or throbbing quality; moderate to severe intensity; and worsened headache by physical activity.1 Secondary headaches are caused by intracranial or medical/systemic disorders.2 For example, a child with brain tumor and headache has a secondary headache. When fever and headache occur simultaneously, the headache is almost universally a secondary headache...."
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