Key Points
Most headaches in children, in the absence of neurologic or systemic findings, require only symptomatic relief with ibuprofen or acetaminophen. Neuroimaging is indicated only with abnormal neurologic features, systemic symptoms, an abrupt change in pattern, or with chronic daily headaches. With recurrent headaches the 1st step in management is promoting healthy lifestyle habits—nutrition, sleep, exercise, hydration, etc. With migraine, DON’T WAIT—medication works best the earlier it is given. Ibuprofen is the initial treatment of choice. If needed, triptans are safe and can be effective.