Pregnancy Headache (other than migraine).Pregnancy Headache Any headache disorder can occur during pregnancy, although the vast majority are migraine or other simple headaches. There are some serious headaches that can occur, but are not at increased risk of happening during pregnancy:
Other headaches are at increased risk during pregnancy, and these are usually vascular syndromes. These include
Accompanying the Reversible Cerebral Vasoconstriction Syndrome in Pregnancy is the Posterior Reversible Leucoencephalopathy Syndrome, which usually is due to pre-eclampsia or eclampsia, and can cause a thunderclap headache, visual disturbance, and there are characteristic white matter changes (Leuco = white matter, encephalopathy = brain disorder) on MRI brain scans. Low pressure headache following inadvertent Cerebrospinal Fluid leak and may complicate epidural or spinal anaesthesia. There are very rare reports of air entering the spine during epidural anaesthesia, and this can cause severe headache, nausea and vomiting as the air works it way up into the head - pneumocephalus (pneumo = air, cephalus = of the head. Air is used to locate the epidural space when trying to position the needle for an epidural anesthetic. If the needle is in fact in the CSF and not the epidural space (the needle may only be one or two millimetres out of place), air will get into the CSF and migrate up to the brain. Another extremely rare complication of low pressure is cortical vein thrombosis. A surface vein on the brain becomes distorted due to lack of support from CSF and subsequently clots off. This can cause persistent headache after pregnancy. It will usually resolve with anti-coagulation or Aspirin, but cases of more serious stroke have been recorded on a few occasions only. After Pregnancy, breastfeeding headache can occur, and, interestingly, may be linked to the mechanism for Sexual Activity Headache. Pregnancy Headache ReferencesLW Katzin et al. Dural puncture headache, postpartum angiopathy, pre-eclampsia and cortical vein thrombosis after an uncomplicated pregnancyCephalalgia 2007;27:461-4 (Free Abstract only)Smarkusky L et al. Acute onset headache complicating labor epidural caused by intrapartum pneumocephalus.Obstet Gynecol. 2006;108:795-8. (Free Abstract only) W.S. BartynskiPosterior Reversible Encephalopathy Syndrome, Part 1: Fundamental Imaging and Clinical FeaturesAJNR Am. J. Neuroradiol.2008; 29: 1036-42 (Free Abstract only)
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