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Child having stabbing pain on the top of head. MRI normal. Required treatment?

Mar 2013
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My 11 yr old daughter has had a stabbing pain at the top of her head for 15 days. It seems tolerable for her most of the day unless there is bright light or loud noise. She also cries that it hurts more in the evening and when she wakes up from sleeping. She seems very tired also. We had an MRI which came back normal and saw her pediatrician today. First off , she is never sick and a very active child, never any other issues, straight A student. I have forced her to get up and play with her siblings and when she starts getting active she complains it hurts her head. Her blood pressure was good at the Dr. office. Her Dr. was very dismissive to her today and said that since her body wasn't showing any signs of distress from being in pain and she wasn't crying in his office that she probably didn't really hurt. He continued to tell me that headaches do not lost this long without any head issues. After that we had some "words" and he ordered a blood test for thyroid and some other things. When we got in the car my daughter started crying and said "he thinks I'm looney". I need a referral to see the Headache specialist. I am afraid to call my pediatrician after the way he spoke to my daughter. Is he warranted in saying that it is impossible to have a headache on the top of your head for this long?
Posted Mon, 18 Mar 2013 in Headache and Migraines
Answered by Dr. Aarti Abraham 20 minutes later
Thanks for your query.

It's unfortunate that the paediatrician was dismissive and apathetic.
Headaches are very common in children, and it is unlikely that your daughter would be malingering about this.

Causes of headaches in kids would be almost the same as in adults, although presentation differs.

From the description given, I would say it sounds like a migraine headache, as these headaches are exacerbated by loud noise or bright lights. Unlike adults, where pain is confined to one side of the head, in children pain can occur on both sides of the head. Migraine headaches can be accompanied by nausea or vomiting or abdominal pain also.

Tension headaches and cluster headaches also occur in children. Stress, anxiety, emotional upheavals, all of which a young child may frequently experience, contribute to Headaches.

Common illnesses such as colds, flu, and ear and sinus infections are some of the most frequent causes of headache in children. More-serious infections, such as meningitis or encephalitis, also can cause headache, but are usually accompanied by other signs and symptoms, such as fever and neck stiffness.

Accidental bumps and bruises can cause headaches.

High levels of stress and anxiety — perhaps triggered by problems with peers, teachers or parents — can play a role in children's headaches. Children with depression may complain of headaches, particularly if they have trouble recognizing feelings of sadness and depression or loneliness.

Headaches, particularly migraines, tend to run in families sometimes.

Nitrates — a kind of food preservative found in such foods as bacon, bologna and hot dogs — have been known to trigger headaches, as can the food additive monosodium glutamate (MSG). Also, too much caffeine — contained in foods such as soda, chocolate, coffee and tea — can cause headaches.

Rarely, a brain tumor or abscess, or bleeding in the brain, may create pressure on areas of the brain, causing a chronic, worsening headache. Typically in these cases, however, headache is accompanied by other symptoms, such as visual problems, dizziness, lack of coordination and other neurological problems.

Feel free to consult your paediatrician and insist on a referral to a Neurologist, as headaches , specially persistent ones should not be neglected in kids.
Do not give her OTC painkillers without a diagnosis, unless the pain is unbearable.
I would also recommended a visual check up, as she has glasses and changing refraction can cause headache.

Offer her love, attention, time and patience, and make sure she doesn't go without meals for prolonged periods as that too can trigger headaches.

All the best.
Feel free to discuss further.
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