Referral guideline – Headache
Headache is a symptom of pain anywhere in the region of the head or neck.
- History and examination
- Concerning features:
- Headaches that wake at night
- Headaches associated with vomiting
- Headaches associated with alterations in consciousness
- Abnormal neurological examination
- Headaches associated with change in mood, mental status or school performance
- Neuroimaging MRI (magnetic resonance imaging) preferred if patient has a headache with concerning features
When to refer
- Patients with a headache and concerning features require URGENT referral to the closest Emergency Department that treats children.
- Refer to a general paediatrician if the patient has a history of recurrent headaches with no concerning features.
- Consider early referral to a neurosurgeon for patients with a headache and a shunt in place.
- General paediatricians should consider referral to QCH neurosciences if:
- patient has ongoing disabling headaches that are not controlled by appropriate analgaesia and first line prophylaxis.
Essential referral info
- Detailed history of headaches (nature, severity, onset, associated symptoms etc.)
- Presence of any concerning features as above
- Medicare number
- Parent/carer name and contact details
- Referring clinician details (name, contact details, provider number, date and length of referral)
Helpful referral info
- Reason for presentation at this time
- Height/weight/head circumference
- Examination findings including fundoscopy and Visual Acuity using Snellen chart
- Birth and developmental history
- Any relevant laboratory tests
- Medication history
- Significant psychosocial risk factors