|A.||Prescribe sumatriptan and review after a week|
Prescribe flunarizine and review after a week
Get an MRI stat
Prescribe anti-anxiety medications and review after a week
Ans. C. Get an MRI stat
Explanation: Headache with vomitings, occipital localization, relieved by vomitings, mostly in the mornings, associated with focal signs, cerebellar signs are warning signs of an underlying brain tumor causing mass effect and raised ICT. In such cases neuroimaging should be a priority, MRI is preferred in a stable child and CT in a hemodynamically unstable child.
Migraine is often throbbing, bifrontal, or bitemporal and accompanied by photophobia, phonophobia, movement sensitivity, and preceded by an aura. So prescribing an anti-migraine medication here would be inappropriate.
Tension headache typically is bilateral, mild to moderate non-throbbing, but usually not associated with vomitings.