Secondary intracranial causes for headaches in children.

Although migraines are the most common cause of headaches in children, it is important to be cognizant of other, secondary causes of headaches. Secondary headaches are caused by an underlying etiology that may be systemic (medical) or due to a problem inherent in the central nervous system. Common intracranial etiologies for headache include structural (eg, tumor, hydrocephalus, Chiari malformation), infection (encephalitis or meningitis), inflammatory (acute disseminated encephalomyelitis, multiple sclerosis, vasculitis), and epilepsy. In some situations, early identification and appropriate treatment of these underlying conditions can result in complete headache resolution. This article discusses these secondary causes of headaches due to primary brain etiologies, focusing on aspects of the history that should lead a neurologist to order neuroimaging or electroencephalographic studies for these children.