Headaches in Children

What Causes Head Pain?

What hurts when you have a headache? The bones of the skull and tissues of the brain itself never hurt because they lack pain-sensitive nerve fibers. Several areas of the head can hurt, including a network of nerves that extends over the scalp and certain nerves in the face, mouth, and throat. Also sensitive to pain (because they contain delicate nerve fibers) are the muscles of the head and blood vessels found along the surface and at the base of the brain.
The ends of these pain-sensitive nerves, called nociceptors, can be stimulated by stress, muscular tension, dilated blood vessels, and other triggers of headaches. Once stimulated, a nociceptor sends a message up the length of the nerve fiber to the nerve cells in the brain, signaling that a part of the body hurts. The message is determined by the location of the nociceptor. A person who suddenly realizes, "My toe hurts" is responding to nociceptors in the foot that have been stimulated by the stubbing of a toe.
A number of chemicals help transmit pain-related information to the brain. Some of these chemicals are natural, painkilling proteins called endorphins (Greek for "the morphine within"). One theory suggests that people who suffer from severe headaches and other types of chronic pain have lower levels of endorphins than people who are generally pain-free.

When to Call the Doctor

It's easy to worry when your child has a headache. But rest assured that most headaches in children are not a symptom of something more serious. However, there are times when you should see your child's healthcare provider. Call the healthcare provider if your child's headaches:
  • Follow an injury, such as a blow to the head
  • Occur once a month or more
  • Are severe
  • Keep him or her out of school
  • Don't go away easily
  • Awaken him or her from sleep (or if he or she has a headache upon awakening)
  • Are accompanied by vomiting or visual changes, seizures, tingling sensations, weakness, or a skin rash
  • Are accompanied by a fever, along with neck pain or stiffness.
You should also call your child's healthcare provider if his or her headache is different from other headaches, or if the headache feels like the worst one that he or she has ever had.
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