 Introduction/Background Headache is a common complaint, even in early childhood. The prevalence of headaches increases with age and ranges from 37% to 51% for children 7 years of age and gradually increases to 57% to 82% by 15 years of age [1]. Prepubertal boys were found to commonly experience more headaches than girls, whereas after puberty, girls were more affected [2]. Headaches can be either primary or secondary in nature. Primary headaches result from the headache condition itself and not from another cause. A secondary headache is a headache that is present because of another condition. Diagnosis of primary headache disorders of children rests principally on clinical criteria as defined by the International Headache Society [3]. The evaluation of a child with headache begins with acquiring a thorough medical history and performing a physical examination with measurement of vital signs, including blood pressure, a complete neurologic examination, and examination of the optic discs. Secondary headache is more common in younger children [7,8]. Most of the secondary headaches have benign etiologies. A single episode of acute headache usually results from an acute infection ranging from viral upper respiratory illness to acute meningitis. Chronic progressive headaches often indicate a serious underlying abnormality, such as a brain tumor, and children with abnormal neurological findings should undergo neuroimaging. The clinical experiences of primary care physicians, pediatricians, and neurologists indicate that neuroimaging studies have a limited role in children with primary headaches [1]. The high prevalence of headaches and the low yield of imaging in pediatric patients presenting with headaches alone bring into question the value of screening for patients with primary headaches. Pediatric headache literature has repeatedly reported that the value of neuroimaging in children with headache is generally low [9-12].
Headache Child PCAs.  Introduction/Background Headache is a common complaint, even in early childhood. The prevalence of headaches increases with age and ranges from 37% to 51% for children 7 years of age and gradually increases to 57% to 82% by 15 years of age [1]. Prepubertal boys were found to commonly experience more headaches than girls, whereas after puberty, girls were more affected [2]. Headaches can be either primary or secondary in nature. Primary headaches result from the headache condition itself and not from another cause. A secondary headache is a headache that is present because of another condition. Diagnosis of primary headache disorders of children rests principally on clinical criteria as defined by the International Headache Society [3]. The evaluation of a child with headache begins with acquiring a thorough medical history and performing a physical examination with measurement of vital signs, including blood pressure, a complete neurologic examination, and examination of the optic discs. Secondary headache is more common in younger children [7,8]. Most of the secondary headaches have benign etiologies. A single episode of acute headache usually results from an acute infection ranging from viral upper respiratory illness to acute meningitis. Chronic progressive headaches often indicate a serious underlying abnormality, such as a brain tumor, and children with abnormal neurological findings should undergo neuroimaging. The clinical experiences of primary care physicians, pediatricians, and neurologists indicate that neuroimaging studies have a limited role in children with primary headaches [1]. The high prevalence of headaches and the low yield of imaging in pediatric patients presenting with headaches alone bring into question the value of screening for patients with primary headaches. Pediatric headache literature has repeatedly reported that the value of neuroimaging in children with headache is generally low [9-12].