Table 3.

Red flags for secondary headache

Headache red flag
Acute onset (<3 months)
Severe vomiting
High-risk underlying comorbidities
Fever
Focal motor abnormality
Changes in mood or personality over days or weeks
Altered conscious state
Seizures
Abnormal ocular movements, squint, pathological pupillary responses
Increase in severity or characteristics of the headache
Pain that wakes the child from sleep or occurs on waking
Ataxia, gait abnormalities, impaired coordination
Meningism
Occipital headache

Adapted from Manoyana et al. [24] according to the Creative Commons License.