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Headache Red Flags — RACP Paediatrics MCQ

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ModerateNeurology & DevelopmentHeadache Red FlagsRACP Paediatrics

A 10-year-old presents with recurrent headaches. Which features would suggest a secondary (sinister) cause requiring urgent neuroimaging?

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Correct answer: A — Headaches worse on lying down, worse in the morning, associated with vomiting, and progressive over weeks

Red flag headache features requiring neuroimaging include: progressive worsening, worse in morning/lying down/straining, nocturnal waking, associated vomiting (especially morning), new neurological signs, personality change, papilloedema, growth failure, and seizures. These suggest raised intracranial pressure from space-occupying lesion.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Headache