Transition of headache care from childhood to adulthood: Focusing needs, barriers, and models of care. A position paper of the IHS Child and Adolescent Committee.

Abstract

Headache disorders are among the most common neurological conditions in children and adolescents, often continuing into adulthood and causing substantial personal and societal burdens. Yet, the transition from childhood to adult headache care remains under-addressed, with critical clinical practice, policy, and research gaps. This narrative review synthesizes existing evidence and expert perspectives to highlight the urgent need for structured, developmentally appropriate transition models in headache care. It explores the evolving clinical features of headache in adolescence, increased vulnerability to different comorbidities, and changing health system expectations. We present a needs assessment reflecting the educational, emotional, and practical demands of patients and families. We identify provider- and system-level barriers, such as insufficient training, limited structured protocols, and inequitable access to specialized care, as significant obstacles to effective continuity. Drawing from established transition of care frameworks in other neurological conditions (e.g., epilepsy), we propose a dual-pathway model for headache care. We suggest key recommendations for clinicians and policymakers to promote anticipatory, patient-centered, and equitable developmental care strategies. International collaboration is essential to establish standardized guidelines and research priorities supporting optimal long-term outcomes and sustained quality of life for young people with headache disorders.