Review ArticleHeadache and PregnancyMenon, Rukmini MD; Bushnell, Cheryl D. MD, MHSAuthor Information From the Department of Neurology, Wake Forest University Health Sciences, Winston-Salem, NC. Reprints: Cheryl Bushnell, MD, MHS, Associate Professor of Neurology, Wake Forest University Health Sciences, Winston-Salem, NC 27157. E-mail: [email protected]. The Neurologist: March 2008 - Volume 14 - Issue 2 - p 108-119 doi: 10.1097/NRL.0b013e3181663555 Buy Metrics Abstract Background: Many women who suffer from migraine and tension-type headaches (TTHs) have an improvement in the frequency of these headaches during pregnancy. At the same time pregnancy predisposes women to a number of potentially life-threatening conditions which can present with headache. Accurate diagnosis and treatment of headache during pregnancy is essential. Review Summary: The primary objectives of this review are to: (1) Summarize the natural history of primary headache disorders, including migraine, tension-type, and cluster headaches during pregnancy, as well as the impact of migraine on pregnancy outcomes and complications.(2) Summarize the therapeutic options and strategies for managing headaches in pregnancy and (3) Discuss the causes of secondary headaches and the diagnostic evaluation for new onset headache during pregnancy. Conclusion: Primary headache disorders, in particular TTHs and migraines, generally improve during pregnancy. However the frequency of improvement varies greatly. Because the pathophysiology of both migraines and TTHs is poorly understood, this limits our ability to predict improvement. Future research should be focused on headache pathophysiology and the effect of ovarian hormones and the pregnant state on headache pathogenesis. © 2008 Lippincott Williams & Wilkins, Inc.