Common problem in children, as well as adults!

Distinguish primary from secondary.

Most headaches get worse with exertion so that’s not a discriminating feature.  Headaches that get worse on standing suggest a CSF leak; worse on lying down suggests a tumour.  See NICE CKS.

Primary

• Migraine
• Tension
• Cluster

Secondary

• Raised intracranial pressure eg hydrocephalus, tumour or other space occupying lesion, idiopathic intracranial hypertension
• Medication overuse headache
• Eye strain, neck strain, dental, sinus related