Headache and Pregnancy

  • Andrea NegroEmail author
  • Dimos Dimitrios Mitsikostas
Part of the Headache book series (HEAD)


Headache during pregnancy can be both primary and secondary and in the last case can be a symptom of a life-threatening condition. Migraine is a risk factor for pregnancy complications, particularly vascular events. It is fundamental looking for the well-known red flags suggesting for a secondary origin of an acute headache during pregnancy. For a differential diagnosis, one or more additional studies can be necessary: brain MRI and MR angiography with contrast, brain CT, ophthalmoscopy, electroencephalography, ultrasound of the vessels of the head and neck, and lumbar puncture. The most common secondary headache is related to preeclampsia, cerebral venous thrombosis (CVT), ischemic or hemorrhagic stroke, subarachnoid hemorrhage (SAH), arterial dissection, reversible cerebral vasoconstriction syndrome (RCVS), posterior reversible leukoencephalopathy syndrome (PRES), idiopathic intracranial hypertension (IIH), and pituitary apoplexy. The preferable management of primary headache during pregnancy and breastfeeding should be non-pharmacological, and only if it is inadequate, the use of medications should be driven by a choice that takes into account all the benefits and possible risks.


Pregnancy Breastfeeding Headache Migraine Complications Treatment Adverse events 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Clinical and Molecular Medicine, Regional Referral Headache Centre, Sant’Andrea HospitalSapienza University of RomeRomeItaly
  2. 2.Neurology Department, Aeginition HospitalNational and Kapodistrian University of AthensAthensGreece

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