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My child has a severe headache - when is a headache dangerous?

Emergency numbers: 108 ambulance · 112 national emergency · Poison centre (AIIMS, 24x7): 1800-116-117

Quick answer: Most childhood headaches come from viral illness, skipped meals, poor sleep, too much screen time or tension - and pass with rest, fluids and a dose of paracetamol. The dangerous headache looks different: the worst headache of your child's life coming on suddenly, a headache with a stiff neck and fever, headache with repeated vomiting, confusion, weakness of one side, or vision changes - those mean the ER now.

🟢 GREEN - You can usually manage at home when

  • A mild-to-moderate headache in a child who is otherwise well - playing, eating, drinking - often with a cold, a hot day, a missed meal or poor sleep.
  • It eases with rest in a quiet room, fluids, food, and one dose of paracetamol in your child's weight-based dose.
  • It is fully gone within a few hours and does not return.

🟡 YELLOW - Call your paediatrician today if

  • Headaches are recurring - several in a month - or slowly becoming more frequent or more severe.
  • The headache keeps your child from normal activities, or wakes them from sleep.
  • Headache with fever that is not settling with the illness.
  • Headaches on most school days - sometimes an eye check or a routine (water, breakfast, screen limits) fixes what medicine cannot.

🔴 RED - Go to the emergency room NOW (call 108 if severe) if

  • A sudden, explosive "worst ever" headache.
  • Headache with a stiff neck - your child cannot bend the neck normally or touch chin to chest - especially with fever. With confusion, drowsiness or a purple rash, call 108.
  • Headache with repeated vomiting, or vomiting in the early morning on waking.
  • Headache with blurred or double vision, weakness or numbness of one arm or leg, slurred speech, or trouble walking.
  • Your child is hard to wake or has passed out.
  • A severe headache after a head injury (see our head injury guide).

🆘 SOS - What to do right now

  • Move your child to a dark, quiet room - light and sound worsen most significant headaches.
  • Offer water and a light snack if the last meal was hours ago.
  • Give paracetamol in the correct weight-based dose; do not stack multiple medicines.
  • Check for the red flags calmly: ask your child to look up at the ceiling, touch chin to chest, smile, raise both arms - note anything that seems off and tell the doctor.
  • If heading to the ER, note when the headache started and how fast it built - "seconds" and "days" point to very different causes.

❌ DO NOT

  • Do not give aspirin to a child or teenager - it is unsafe for them.
  • Do not give adult-strength or combination painkillers to a child.
  • Do not let a child with a severe or stiff-neck headache sleep it off unobserved.
  • Do not dismiss recurring headaches as drama or exam stress without a medical visit - children rarely invent pain that interrupts play.

What is happening and why

A child's headache is almost always pain in the tissues around the brain, not the brain itself - tight muscles, a feverish body, a hungry one, a tired one. The AAP's headache guidance reserves its emergency list for the patterns that suggest pressure or infection inside the skull: meningitis (stiff neck, fever, confusion; in younger children, lethargy or irritability that cannot be consoled), bleeding (sudden worst-ever pain), and pressure build-up (morning vomiting, worsening over weeks, vision changes).

Migraine is real in children too - throbbing, often one-sided, with nausea and a need to lie in a dark room, and it usually runs in the family. It is miserable but not dangerous, and your paediatrician can help manage it once the dangerous patterns are ruled out.

This page is for first-aid education and does not replace examination by a doctor. In an emergency, call 108 or 112.

Sources (last checked 13 Sep 2026)

Approved for publication by Dr Anjana Alekhya, MD (Paediatrics) · Based only on AAP/IAP guidance · Published 13 September 2026