Referral guideline – Headache

Introduction

Headache is a symptom of pain anywhere in the region of the head or neck.

GP management

  • 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 LCCH 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

Parent service

Neurosciences

Contact details

Hospital Switchboard
(Ask for the General Paediatric Registrar)
t: 07 3068 1111

Resources

International Classification of Headache Disorders