CONTINUUM: Lifelong Learning in Neurology:
doi: 10.1212/01.CON.0000443841.40933.9e
Review Articles

Headache in Pregnancy

MacGregor, E. Anne MB BS, MD, FFSRH, MICR

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Abstract

Purpose of Review

This article provides an overview of the diagnosis and management of primary and secondary headaches that may occur during pregnancy and postpartum. Headache presenting in pregnancy is of significant concern to the affected woman. Quick and correct diagnosis leads to the optimal management, minimizing risks to the pregnancy.

Recent Findings

Several strategies have been developed to distinguish secondary headaches that need urgent assessment and management from benign primary and secondary headaches and to minimize the risk of misdiagnosis. Recent guidelines for the drug treatment of headaches are considered in the context of updated information on the safety of drugs in pregnancy and lactation.

Summary

Primary headaches are common and typically improve during pregnancy. Management during pregnancy and lactation is similar to management in the nonpregnant state, with a few exceptions. Secondary causes of headache that are more likely to occur during pregnancy include cerebral venous thrombosis, posterior reversible encephalopathy syndrome resulting from eclampsia, post–dural puncture headache, stroke, and pituitary apoplexy.

Copyright © 2014 by the American Academy of Neurology.

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