Headaches During Pregnancy

Digre, Kathleen B.

doi:10.1097/grf.0b013e31828f25e6

Cited by 25 publications

(11 citation statements)

References 78 publications

(70 reference statements)

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“…Neurological deficits are also commonly seen. 4,9 The specific presentation depends on location and extent of the thrombosis and the presence of associated cortical lesions like the diminution of vision noted in our patient were because of venous infarction involving left occipital cortex and subcortical white matter corresponding to visual area. MR Venography is the diagnostic modality of choice for the diagnosis of CVT in pregnant women.…”

Section: Discussionmentioning

confidence: 75%

A rare case of post-partum cerebral venous sinus thrombosis

Singh

Vardhan

2018

Int J Reprod Contracept Obstet Gynecol

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Cerebral venous sinus thrombosis is a rare neurologic emergency during pregnancy. Life threatening complications can be prevented if it is detected and treated well in time. A 24 years P2L3A2 lady, who had undergone elective caesarean delivery developed sudden onset severe episodic parieto-occipital headache and bilateral diminution of vision on 4th post-partum day. She had no known risk factors for thrombosis. There was no history suggestive of sepsis or pre-eclampsia. On clinical examination her blood pressure was found to be very high (164-180/104-110 mm Hg). There was no sensory or motor deficit. Relevant haematological and biochemical investigations were within normal limits. Urinary protein was negative. With a provisional diagnosis of imminent eclampsia, she was put on antihypertensive and Magnesium Sulphate. However, in view of persistence of the symptoms even after 24 hours, contrast-enhanced computed tomography (CECT) was done, which revealed venous infarction in occipital cortex and subcortical white matter. Magnetic resonance (MR) venography confirmed thrombus in left transverse and sigmoid sinuses. Thus, definitive treatment in the form of heparin in therapeutic doses was started. Antihypertensive was continued and prophylactic anticonvulsant was added in view of presence of the infarction. Patient responded well. Vision improved, and headache resolved completely. The patient was discharged on antihypertensive, anticonvulsant and vitamin K antagonist (Warfarin sodium) with an advice of regular follow-up. Cerebral venous thrombosis (CVT) is an uncommon entity and a high index of suspicion is needed to diagnose it at an earlier stage for timely initiation of treatment and prevention of complications. Prognosis in pregnant cases is better than that during a non-pregnant state.

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Section: Discussionmentioning

confidence: 75%

A rare case of post-partum cerebral venous sinus thrombosis

Singh

Vardhan

2018

Int J Reprod Contracept Obstet Gynecol

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“…7 For example, in the Norwegian Head-HUNT study of over 27,000 women, 60% of women younger than 40 years of age surveyed had experienced a headache within the previous year. 8 The same study included a cohort of 550 pregnant women and demonstrated an incidence of headache ranged from 39% to 59%, depending on the trimester in which they were queried.…”

Section: Association Of Headache and Preeclampsiamentioning

confidence: 98%

The Role of Headache in the Classification and Management of Hypertensive Disorders in Pregnancy

Sperling

Dahlke

Huber

et al. 2015

Obstetrics &Amp; Gynecology

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Hypertensive disorders of pregnancy remain among the leading causes of maternal morbidity and mortality. The onset of headaches in patients with hypertensive disorders of pregnancy has been considered as a premonitory symptom for eclampsia and other adverse maternal outcomes. Headaches are very common symptoms during pregnancy and the postpartum period with a reported incidence of 39%; however, headache is absent in 30-50% of women before the onset of eclampsia and is a poor predictor of eclampsia and adverse maternal outcomes. If included in the definition of cerebral or visual disturbances, headache may be considered a symptom of preeclampsia, a diagnostic feature of preeclampsia with severe features, a premonitory symptom of eclampsia, and an indication for delivery. Inclusion of this nonspecific symptom in the diagnosis and management of hypertensive disorders of pregnancy in the absence of an evidence basis may lead to unintended consequences including excessive testing, visits to outpatient offices or emergency departments, additional hospitalization, and iatrogenic preterm delivery without proven benefit. If a cerebral disturbance such as severe or persistent headache presents for the first time during pregnancy or postpartum, an evaluation should be performed that considers a broad differential diagnosis, including but not limited to hypertensive disorders of pregnancy, and the diagnostic evaluation is similar to that in nonpregnant adults. This commentary draws attention to the implications of considering the cerebral disturbance of headache as a symptom that portends adverse pregnancy outcome in the current recommendations for diagnosing and managing hypertensive disorders of pregnancy.

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“…171 Because many of these diseases during pregnancy cause headaches, determining if the headache is a primary headache, such as migraine or tension headache, or a secondary headache from one of these pregnancy-specific diseases becomes imperative. 172 One of the most common pregnancy-specific diseases is pre-eclampsia, characterized by hypertension and proteinuria, and is often associated with headaches. In severe cases, patients with preeclampsia can develop eclampsia and demonstrate seizures and/or coma.…”

Section: Pregnancymentioning

confidence: 99%

Sex Disparities in Neuro-Ophthalmologic Disorders

Chen

Costello

Kardon

2014

Current Eye Research

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Many neuro-ophthalmic diseases have a clear sex predilection, which is important to recognize in making the diagnosis based on risk stratification and understanding the pathogenesis of the disease. This review discusses the more common neuro-ophthalmic diseases with a female predilection, including idiopathic intracranial hypertension, cerebral venous sinus thrombosis, meningioma, multiple sclerosis, migraine, breast-cancer associated neuro-ophthalmic manifestations, sarcoidosis, bisphosphonate-associated orbital inflammation, and pregnancy-related neuro-ophthalmic disorders. In addition, the male predominance in the clinical manifestation of Leber's Hereditary Optic Neuropathy is discussed. Lastly, the etiology of the sex discrepancies for each disease is explored.

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Headaches During Pregnancy

Cited by 25 publications

References 78 publications

A rare case of post-partum cerebral venous sinus thrombosis

A rare case of post-partum cerebral venous sinus thrombosis

The Role of Headache in the Classification and Management of Hypertensive Disorders in Pregnancy

Sex Disparities in Neuro-Ophthalmologic Disorders

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