Background: Headache is common in children with school attendance difficulties, but is not always presented as a chief complaint.
Objective: To clarify the clinical features of pediatric headache and its association with school absenteeism in a general pediatric outpatient setting.
Methods: We conducted a case-based analysis, a retrospective study of 66 patients with headache lasting ≥1 month, and a questionnaire survey of pediatric outpatients.
Results: Headache frequently coexisted with fatigue, gastrointestinal symptoms, sleep disturbances, and school attendance problems, many of which persisted at 1 year. Headache was reported in 37% of outpatients and was associated with higher rates of school absenteeism. Notably, headache was often not the chief complaint.
Conclusions: Headache may be overlooked in pediatric outpatient practice when not presented as a chief complaint. Systematic assessment beyond the presenting complaint, including functional and psychosocial aspects, is essential.
