Emergency Department Management of Pediatric Headaches

To describe treatment of pediatric headache in U.S. emergency departments (EDs), investigators reviewed National Hospital Ambulatory Medical Care Survey data from 2005 to 2009 for visits by children with a primary ED discharge diagnosis of headache or migraine. Patients with trauma or central nervous system neoplasms were excluded.

In a sample of 448 visits (representative of 1.7 million ED visits for pediatric headache), treatments included nonsteroidal anti-inflammatory agents (NSAIDs; 40%), opioids (27%), dopamine antagonists (27%), acetaminophen (16%), and antibiotics (10%). Overall, 35% of children received head computed tomography, which revealed only incidental findings in a small minority of patients. Children with migraine were more…