Headache, along with seizure disorders and various psychomotor developmental and learning problems, constitute the bulk of reasons for referral for the opinion of a child neurologist. It is apparent that these problems tend to make the pediatrician sufficiently "nervous" to desire a second opinion in order to share the diagnostic and management responsibility. The overwhelming majority of these symptomatic manifestations of disease are based on medically benign or static processes, but the pediatrician and the pediatric neurologist both know that tucked in amongst this large group of patients are those with progressive, sometimes remediable, disease, including brain tumor. Although computed tomography (CT) has become widely available as a simple, relatively noninvasive, and reasonably inexpensive method of intracranial imaging, it cannot be recommended as a routine approach to screen all young patients with headache or seizure disorder. We require a set of clinical clues that raise the index of suspicion