Child health · UKMLA & AKT

Tension headache

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise tension headache — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • TTH is a clinical diagnosis of exclusion - red flags must be ruled out first. The exam question highlights that a child with headache, visual field defect, and growth failure points away from TTH.
  • Thunderclap onset - suspect subarachnoid haemorrhage
  • Fever, neck stiffness, photophobia - suspect meningitis/encephalitis
  • New focal neurological signs, papilloedema - suspect raised ICP or space-occupying lesion
  • Headache worsened by Valsalva - suspect raised ICP
  • Morning headache worsening on waking - suspect raised ICP
  • Headache + visual field defect + growth failure in a child - consider craniopharyngioma or pituitary lesion

Bitemporal superior quadrantanopia + short stature + headache = pituitary adenoma. Craniopharyngioma gives bitemporal INFERIOR quadrantanopia. Do not confuse the two.

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