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Brain imaging in pregnant women with acute headache

  • Bianca Raffaelli
  • Lars Neeb
  • Heike Israel-Willner
  • Jeannette Körner
  • Thomas Liman
  • Uwe Reuter
  • Eberhard Siebert
Original Communication
  • 27 Downloads

Abstract

Background

Brain imaging is one of the most important diagnostic methods for evaluating headache during pregnancy. In this study, we aimed to identify anamnestic and clinical predictors for pathological brain imaging findings in pregnant women suffering from acute headache.

Methods

We conducted a retrospective chart review of 151 pregnant women with acute headache between 2010 and 2016. We screened the medical records of these patients and analyzed radiological variables, including brain imaging frequency and modality, delay to imaging and imaging findings. In patients with brain imaging, we compared several anamnestic and clinical features between those with and without symptomatic pathological findings.

Results

Half of the patients (50.3%) underwent brain imaging, mainly magnetic resonance imaging (MRI) including venography (53.9%) or MRI including both venography and arteriography (31.6%). Symptomatic pathological results could be observed in 27.6% of the patients with a brain scan. Patients in the first trimester with acute headache had a statistically higher risk for a symptomatic pathological imaging finding (p = 0.024). Strong pain intensity, a reduced level of consciousness and seizures were significantly associated with a symptomatic pathological imaging outcome across all stages of pregnancy.

Conclusion

Brain imaging may reveal a secondary headache etiology in more than 25% of pregnant women presenting with acute headache. In particular, when the acute headache is of severe intensity, and the headache is accompanied by seizures or a change in consciousness, brain imaging is required.

Keywords

Headache Pregnancy Secondary headache Brain imaging Red flags 

Notes

Funding

None.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical standards

Informed consent from patients as well as approval from the ethical review committee were not required due to the retrospective review of medical records.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Bianca Raffaelli
    • 1
  • Lars Neeb
    • 1
  • Heike Israel-Willner
    • 1
  • Jeannette Körner
    • 1
  • Thomas Liman
    • 1
  • Uwe Reuter
    • 1
  • Eberhard Siebert
    • 2
  1. 1.Department of NeurologyCharité Universitätsmedizin BerlinBerlinGermany
  2. 2.Institute of NeuroradiologyCharité Universitätsmedizin BerlinBerlinGermany

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