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Headaches are common in children and teenagers. Though a headache can be an early sign of a wide variety of illnesses, ranging from the common cold to more serious infections, the most frequent cause by far is stress. Think of the child who for days has been memorizing his part in the school play or the child who's been practising extra hours after school on the gymnastics team. Fatigue, tension and anticipation often combine to produce changes in the blood flow to the muscles of the head and neck, causing a headache.

When a young child complains of a headache, call the doctor promptly, because it's more likely at this age that the headache is an early symptom of an oncoming illness. An older child who has a headache can be given the appropriate dose of paracetamol or ibuprofen, followed by a rest period - lying down, playing, Quietly or engaging in another restful activity- until the medicine starts to work. Sometimes an ice pack helps. If a headache lasts as long as four hours after the child has taken a medication or other symptoms of illness (such as fever) appear, the doctor or nurse practitioner should be called.

A child who has frequent headaches should have a thorough physical examination, including a check of his vision, a dental exam, a neurological evaluation and a careful review of the, child's diet. It's also worth considering whether something in the child's home life, school or social activities may be causing undue stress.

Children do get migraine headaches, although they are less likely to have characteristic migraine symptoms, such as an aura of flashing lights or other visual changes or weakness in one extremity. A pattern of severe headaches in a child should indicate the possibility of migraines, especially (though not only) if they run in the family.

If a headache comes on after a fall or a blow to the head, get in touch with the doctor promptly. Headaches on rising or in the morning or that wake a child at night are often signs of serious illness. Discuss with your child's doctor any recurrent early­morning headaches and any associated with dizziness, blurred or double vision, nausea and vomiting.

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