Abstract
Headaches are the most common type pain symptom in childhood and adolescence; they not only create difficulties for the patient and his/her family, but may also cause the treating physician to shake his head. The concerns of the parents become those of the physician and as a result headaches are the most reason for referring school children for tertiary pediatric neurology consultation (1). The first question concerns the possible causes: how certain can the physician be when employing just history and clinical examination that he/she is not dealing with symptomatic (secondary) headaches, especially as a sign of an underlying a brain tumor? The next question is the diagnosis of what type of headache: how reliable and valid are the international criteria for the classification of headaches in children and adolescents? Even after the physician has decided his/her patient has chronic primary headaches, a third question remains to be answered: what is the appropriate management in this special age group. The article in this issue of Deutsches Artzeblatt International by Straube et al. (2) reviews this complex subject while providing some answers for these practical daily questions.
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