妊娠期头痛
Headache in pregnancy.
作者信息
Macgregor E Anne
出版信息
Continuum (Minneap Minn). 2014 Feb;20(1 Neurology of Pregnancy):128-47. doi: 10.1212/01.CON.0000443841.40933.9e.
PURPOSE OF REVIEW
This article provides an overview of the diagnosis and management of primary and secondary headaches that may occur during pregnancy and postpartum. Headache presenting in pregnancy is of significant concern to the affected woman. Quick and correct diagnosis leads to the optimal management, minimizing risks to the pregnancy.
RECENT FINDINGS
Several strategies have been developed to distinguish secondary headaches that need urgent assessment and management from benign primary and secondary headaches and to minimize the risk of misdiagnosis. Recent guidelines for the drug treatment of headaches are considered in the context of updated information on the safety of drugs in pregnancy and lactation.
SUMMARY
Primary headaches are common and typically improve during pregnancy. Management during pregnancy and lactation is similar to management in the nonpregnant state, with a few exceptions. Secondary causes of headache that are more likely to occur during pregnancy include cerebral venous thrombosis, posterior reversible encephalopathy syndrome resulting from eclampsia, post-dural puncture headache, stroke, and pituitary apoplexy.
综述目的
本文概述了妊娠期间和产后可能出现的原发性和继发性头痛的诊断与管理。妊娠期间出现的头痛是受影响女性极为关注的问题。快速且正确的诊断有助于实现最佳管理，将对妊娠的风险降至最低。
最新发现
已制定了多种策略，以区分需要紧急评估和管理的继发性头痛与良性原发性和继发性头痛，并将误诊风险降至最低。在更新了关于药物在妊娠和哺乳期安全性信息的背景下，对近期头痛药物治疗指南进行了考量。
总结
原发性头痛很常见，且在妊娠期间通常会有所改善。妊娠和哺乳期的管理与非妊娠状态下的管理相似，但有一些例外情况。妊娠期间更易发生的继发性头痛原因包括脑静脉血栓形成、子痫导致的后部可逆性脑病综合征、硬膜穿刺后头痛、中风和垂体卒中。
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