ABSTRACT
Headaches are a common complaint for most women during their lifetime, including gestation
and puerperium. Tension-type headaches and migraine flare-ups are the most common
headache complications after delivery, but the differential diagnosis of postpartum
headache is broad. The clinician must distinguish common headache syndromes from dangerous
causes of postpartum headache. We will focus on early postpartum headaches in the
form of case discussions that will include clinical presentation, diagnostic criteria,
and treatment.
KEYWORDS
Headache - pregnancy - postpartum - women - treatment
REFERENCES
- 1
Waters W E, O'Connor P J.
Epidemiology of headache and migraine in women.
J Neurol Neurosurg Psychiatry.
1971;
34
(2)
148-153
- 2
Maggioni F, Alessi C, Maggino T, Zanchin G.
Headache during pregnancy.
Cephalalgia.
1997;
17
(7)
765-769
- 3
Scharff L, Marcus D A, Turk D C.
Headache during pregnancy and in the postpartum: a prospective study.
Headache.
1997;
37
(4)
203-210
- 4
Headache H B.
Neurol Clin.
1994;
12
443
- 5
Headache Classification Subcommittee of the International Headache Society .
The International Classification of Headache Disorders: 2nd ed.
Cephalalgia.
2004;
24
(Suppl 1)
9-160
- 6
Sances G, Granella F, Nappi R E et al..
Course of migraine during pregnancy and postpartum: a prospective study.
Cephalalgia.
2003;
23
(3)
197-205
- 7
Goldszmidt E, Kern R, Chaput A, Macarthur A.
The incidence and etiology of postpartum headaches: a prospective cohort study.
Can J Anaesth.
2005;
52
(9)
971-977
- 8
Marcus D A.
Interrelationships of neurochemicals, estrogen, and recurring headache.
Pain.
1995;
62
(2)
129-139
- 9
Somerville B W.
Estrogen-withdrawal migraine. I. Duration of exposure required and attempted prophylaxis
by premenstrual estrogen administration.
Neurology.
1975;
25
(3)
239-244
- 10
Somerville B W.
The role of progesterone in menstrual migraine.
Neurology.
1971;
21
(8)
853-859
- 11
Stein G, Morton J, Marsh A et al..
Headaches after childbirth.
Acta Neurol Scand.
1984;
69
(2)
74-79
- 12
Wall V R.
Breastfeeding and migraine headaches.
J Hum Lact.
1992;
8
(4)
209-212
- 13
Liberman A, Karussis D, Ben-Hur T, Abramsky O, Leker R R.
Natural course and pathogenesis of transient focal neurologic symptoms during pregnancy.
Arch Neurol.
2008;
65
(2)
218-220
- 14
Bushnell C D, Jamison M, James A H.
Migraines during pregnancy linked to stroke and vascular diseases: US population based
case-control study.
BMJ.
2009;
338
b664
- 15
Aromaa M, Rautava P, Helenius H, Sillanpää M L.
Prepregnancy headache and the well-being of mother and newborn.
Headache.
1996;
36
(7)
409-415
- 16
Menon R, Bushnell C D.
Headache and pregnancy.
Neurologist.
2008;
14
(2)
108-119
- 17
Evans R W, Tepper S J, Shapiro R E, Sun-Edelstein C, Tietjen G E.
The FDA alert on serotonin syndrome with use of triptans combined with selective serotonin
reuptake inhibitors or selective serotonin-norepinephrine reuptake inhibitors: American
Headache Society position paper.
Headache.
2010;
50
(6)
1089-1099
- 18
Rasmussen B K.
Migraine and tension-type headache in a general population: precipitating factors,
female hormones, sleep pattern and relation to lifestyle.
Pain.
1993;
53
(1)
65-72
- 19
ACOG Committee on Practice Bulletins--Obstetrics .
ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number
33, January 2002.
Obstet Gynecol.
2002;
99
(1)
159-167
- 20
Hart R G, Easton J D.
Dissections of cervical and cerebral arteries.
Neurol Clin.
1983;
1
(1)
155-182
- 21
Müllges W, Ringelstein E B, Leibold M.
Non-invasive diagnosis of internal carotid artery dissections.
J Neurol Neurosurg Psychiatry.
1992;
55
(2)
98-104
- 22
Mokri B, Piepgras D G, Houser O W.
Traumatic dissections of the extracranial internal carotid artery.
J Neurosurg.
1988;
68
(2)
189-197
- 23
Biousse V, D'Anglejan J, Touboui P J et al..
Headache in 67 patients with extracranial internal carotid artery dissection.
Cephalalgia.
1991;
11
232-233
- 24
Silbert P L, Mokri B, Schievink W I.
Headache and neck pain in spontaneous internal carotid and vertebral artery dissections.
Neurology.
1995;
45
(8)
1517-1522
- 25
Gdynia H J, Huber R.
Bilateral internal carotid artery dissections related to pregnancy and childbirth.
Eur J Med Res.
2008;
13
(5)
229-230
- 26
Arnold M, Camus-Jacqmin M, Stapf C et al..
Postpartum cervicocephalic artery dissection.
Stroke.
2008;
39
(8)
2377-2379
- 27
Wiebers D O, Mokri B.
Internal carotid artery dissection after childbirth.
Stroke.
1985;
16
(6)
956-959
- 28
Stamboulis E, Raptis G, Andrikopoulou A et al..
Spontaneous internal carotid artery dissection: an uncommon cause of recurrent postpartum
headache.
J Neuroimaging.
2011;
21
(1)
76-78
- 29
Fusco M R, Harrigan M R.
Cerebrovascular dissections—a review part I: Spontaneous dissections.
Neurosurgery.
2011;
68
(1)
242-257
discussion 257
- 30
Klein A M, Loder E.
Postpartum headache.
Int J Obstet Anesth.
2010;
19
(4)
422-430
Luzma CardonaM.D.
Instructor in Neurology, Brigham and Women's Hospital, Faulkner Hospital
1153 Centre Street, Boston, MA 02130
Email: lcardona@partners.org
