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Headache Clinical Pathway – Primary Care

Primary Care Clinical Pathway for Evaluation
and Management of Child with Headache

 
 
 
 
 
 

No/Low Concern for Secondary Headache

Normal neurologic exam
 
 
Consider Primary Headache
Neuroimaging not routinely recommended for
child with recurrent headache and normal exam
 
 
 
 
 
 
 
 
Refer to ED
or
Urgent Neurology Consult
 
 
 
 
  • PCP follow-up:
    • Assess response to treatment
    • Reassess symptoms
  • Refer to Neurology as needed for:
    • Unclear diagnosis
    • Inadequate treatment response
    • Headache symptoms worsening
    • New or changing symptoms
Outpatient Evaluation

Brain MRI with and
without contrast
Indicate in the order: contrast given at radiologist’s discretion

and/or

PCP follow-up to reassess symptoms, labs as indicated

and/or

Refer to Neurology
Indicate urgency of follow-up

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