• Am J Emerg Med · Oct 2023

    Review

    Acute headache in pregnant and post-partum patients: A clinical review.

    • Tatiana Greige, Leslie A Bilello, Jennifer M Singleton, and Jonathan A Edlow.
    • Boston Medical Center, Department of Neurology, One Boston Medical Center Pl, Boston, MA 02118, United States of America. Electronic address: tatiana.greige@bmc.org.
    • Am J Emerg Med. 2023 Oct 1; 72: 161916-19.

    BackgroundHeadaches during pregnancy and the post-partum period may be due to either an exacerbation of a pre-existing neurological presentation, a new pregnancy-related process, or a non-pregnancy related condition. Key physiologic changes during pregnancy and the post-partum period contribute to the vulnerability of this patient population and the increased risk of complications.Objective Of The ReviewReview causes of headaches in pregnant and post-partum patients as well as neuroimaging techniques performed.DiscussionHeadaches are a common complaint for pregnant and post-partum patients. For pregnant patients, a range of serious causes must be considered including cerebral venous thrombosis, posterior reversible encephalopathy syndrome and stroke. Primary headaches are responsible for most post-partum headaches, however other causes also include pre-clampsia, cerebral venous thrombosis and post-dural headache. Determining the optimal imaging technique in this vulnerable population remains a challenge given the scarce guidelines.ConclusionThe greatest difficulty while evaluating pregnant and post-partum patients presenting with an acute headache in an emergency setting is to determine whether the headache is due to a primary disorder such as migraines or is secondary to an underlying, sometimes serious pathology. The following review explores evidenced-based diagnosis of headache in this particular setting.Copyright © 2023 Elsevier Inc. All rights reserved.

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