Postpartum headache: is your work-up complete?

Stella, Caroline L.; Jodicke, Cristiano; How, Helen; Harkness, Ursula F.; Sibai, Bahaeddine M

doi:10.1016/j.ajog.2007.01.034

Cited by 119 publications

(91 citation statements)

References 37 publications

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“…Headache is a well-known symptom in eclampsia/preeclampsia [8,9,10]. It is also common after delivery [11, 12]. It has further been suggested that there is a connection between preeclampsia and migraine [13].…”

Section: Discussionmentioning

confidence: 99%

Posterior Reversible Encephalopathy Syndrome: Is There a Difference between Pregnant and Non-Pregnant Patients?

Roth

Ferbert

2009

Eur Neurol

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Background: Clinical and imaging abnormalities similar to those seen in posterior reversible encephalopathy syndrome (PRES) have been observed in patients with eclampsia. It remains unclear whether both conditions are in fact the same disease entity. Methods: We retrospectively identified 21 patients with PRES and separated them into 2 groups: patients who were symptomatic during pregnancy, and a group of non-pregnant patients. We recorded symptoms, premedical history and paraclinical investigations of both groups and compared them to each other. Results: We found 8 pregnant patients and 13 non-pregnant patients with PRES. There was no difference between both groups with regard to symptoms, cerebral imaging, or outcome, apart from a difference in age, the premedical history and a significantly higher occurrence of headache in the pregnant group. All of our pregnant women were primigravid. Follow-up was done over a mean period of 2,171 (range 59–9,396) days. Overall, there was a good clinical outcome. Conclusion: We suggest that PRES in non-pregnant patients and eclampsia presenting with MRI abnormalities similar to those seen in PRES represent the same disease entity, but are triggered by different pathologies.

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Section: Discussionmentioning

confidence: 99%

Posterior Reversible Encephalopathy Syndrome: Is There a Difference between Pregnant and Non-Pregnant Patients?

Roth

Ferbert

2009

Eur Neurol

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“…Se pueden clasificar las cefaleas en primarias y secundarias. Dentro de las cefaleas primarias encontramos la migraña, la cefalea tensional y la cefalea en racimo; y como cefaleas secundarias están posterior a anestesia regional, complicaciones obstétricas o de lesiones neurológicas como la hemorragia intracraneal espontánea (HIE) 1 .…”

Section: Discussionunclassified

Hemorragia intracraneal espontánea durante el puerperio: estudio de caso

Báez¹,

Maestre²,

Guevara³

et al. 2017

Rev Col Med Fis Reh

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RESUMENLa cefalea es un hallazgo frecuente en el periodo posparto por causas multifactoriales, siendo una de ellas, aunque no la más frecuente, la hemorragia intracraneal espontánea (HIE). Esta etiología tiene diferentes tasas de incidencia de acuerdo con la población tratada, con causas claramente establecidas en puerperio como lo son la ruptura de aneurisma y/o malformaciones vasculares. Presentamos el caso de una mujer puérpera joven, sin antecedentes de importancia, quien consulta al servicio de urgencias por cefalea, con estudios iniciales aparentemente normales, sin factores de riesgo importantes como presencia de hipertensión arterial, con posterior progresión a una HIE, descartando de forma inicial las causas más frecuentes para estos casos. El siguiente estudio de caso busca encontrar posibles etiologías de menor prevalencia que se ajusten con el cuadro de la paciente, además de factores pronósticos en el momento de realizar el proceso de rehabilitación. Palabras clave: Posparto, hemorragia intracerebral, hemorragia subaracnoidea, ataque cerebrovascular hemorrágico, rehabilitación, factores predictivos de funcionalidad. ABSTRACTHeadache is a frequent finding in the postpartum period due to multifactorial causes, one of them, although not the most frequent one, is spontaneous intracranial hemorrhage (HIE). This etiology has different incidence rates according to the treated population, with clearly established causes in the puerperium such as aneurysm rupture and / or vascular malformations. We present the case of a young puerperal woman, without important antecedents, who consults with the emergency department with headache, with apparently normal initial studies, without important risk factors like presence of arterial hypertension, with progression to an HIE, initially discarding the causes more frequent for these cases. The following case study seeks to find possible etiologies of lower prevalence that fit with the patient's condition, in addition to prognostic factors at the time of the rehabilitation process.

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“…Ce diagnostic d'éclampsie retardée est donc difficile à prévoir et à prévenir. Il semble alors important de bien éduquer les patientes, prééclamptiques connues ou non, de leur apprendre à consulter rapidement dans les quatre semaines suivant l'accouchement devant l'apparition de tels symptômes et d'avoir un algorithme de prise en charge de céphalées importantes en post-partum, même tardif, incluant la possibilité d'éclampsie imminente [10]. L'IRM de l'éclampsie tardive du post-partum est de connaissance récente.…”

Section: Discussionunclassified