Headaches During Pregnancy

Headaches during pregnancy are common. About 16% of all women experience migraine headaches whether pregnant or not. During pregnancy, it is quite likely that the amount of migraine will reduce, by as much as 50%, especially in the second and third trimesters. This is probably due to the increase in pain threshold brought about by pregnancy hormones.

The usual reason for being consulted during pregnancy is for headache and some sort of other accompanying symptom like numbness, visual disturbance or speech disturbance. In my own experience (borne out by a recent study from Norway) almost all of these new headaches and neurological symptoms are due to migraine. A severe headache disorder occurring for the first time during pregnancy is actually quite rare.

You can read more migraine treatment during pregnancy, but I really want to say something about other headache types that occur during pregnancy.

The other severe headaches in pregnancy that cause concern are:

1. Reversible Cerebral Vasoconstriction Syndrome
• Associated with eclampsia
• Not associated with eclampsia - so called post-partum angiopathy
2. Posterior Reversible Leucoencephalopathy
3. Venous Sinus Thrombosis
4. Low pressure headache complicating epidural anaesthesia
• Inadvertent CSF leak
• Iatrogenic Pneumocephalus (if air injection was used to site epidural needle)
5. Headaches associated with eclampsia
6. Hemicrania Continua