Neurology Book

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Headache in Pregnancy

Aka: Headache in Pregnancy, Migraine in Pregnancy, Antepartum Headache, Postpartum Headache
  1. See Also
    1. Pregnancy Induced Hypertension
    2. Menstrual Migraine
  2. Types: Primary Headaches
    1. Tension Headache
    2. Migraine Headache
      1. Improves with pregnancy in up to 70% of patients
      2. Some cases of first Migraine occur in first trimester
        1. Associated with aura
    3. Chronic Daily Headache
  3. Differential Diagnosis: Secondary Headaches in Antepartum Period
    1. See Headache for other causes
    2. See Headache Red Flags
    3. Pregnancy Induced Hypertension (Preeclampsia)
      1. Consider after 20 weeks
  4. Differential Diagnosis: Secondary Headaches in Postpartum Period (Postpartum Headache)
    1. See Headache for other causes
    2. See Headache Red Flags
    3. Pregnancy Induced Hypertension (Preeclampsia)
      1. May occur up to 6 weeks after delivery
      2. Critical diagnosis commonly missed in postpartum patients (Magnesium IV is drug of choice)
      3. Evaluate for Hypertension and Proteinuria (or alternative criteria) in all Postpartum Headache patients
    4. Posterior Reversible Encephalopathy Syndrome (PRES)
    5. Reversible Cerebral Vasoconstriction Syndrome
      1. Thunderclap Headache
    6. Post-epidural Headache
      1. Spinal Headache (Post-Lumbar puncture headache)
      2. Pneumocephalus
    7. Cerebral Venous Thrombosis (Cortical Vein Thrombosis)
    8. Spontaneous Subarachnoid Hemorrhage
    9. Meningitis
    10. Pituitary Apoplexy
  5. Management
    1. See Nonpharmacologic Headache Treatment
    2. See Headache Medications in Pregnancy
    3. See Headache Medications in Lactation
  6. References
    1. Jhun, Weinstock and Jaque in Herbert (2017) EM:Rap 17(1): 14-5
    2. Johnson (2004) Prim Care Office Pract 31:417-28
    3. Gregory (2018) Am Fam Physician 98(9): 595-602 [PubMed]
    4. Silberstein (2004) Neurol Clin 22:727-56 [PubMed]

Postpartum headache (C0522250)

Concepts Sign or Symptom (T184)
SnomedCT 103008008
English headache associated with postpartum status (symptom), headache associated with postpartum status, postpartum headache, Postpartum headache, Postpartum headache (finding)
Spanish cefalea posparto, cefalea postparto (hallazgo), cefalea postparto
Sources
Derived from the NIH UMLS (Unified Medical Language System)


headache associated with pregnancy (C2029699)

Concepts Sign or Symptom (T184)
English headache associated with pregnancy (symptom), headache associated with pregnancy
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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