Yang Sara, Han Jane J, Patadia Monica
Department of Otolaryngology Head and Neck Surgery, Loyola University Medical Center, Maywood, IL, USA.
Stritch School of Medicine, Loyola University, Maywood, IL, USA.
Obstet Med. 2021 Dec;14(4):257-259. doi: 10.1177/1753495X20970095. Epub 2020 Nov 26.
The incidence of headaches during pregnancy is 35%. Although ruling out pre-eclampsia as a possible cause for headache is important in the pregnant population, acute sinusitis should remain on the differential as it occurs six times more frequently in pregnant women. Untreated disease can lead to rare intracranial complications such as a subdural empyema. 21-year-old female with recurring headaches at 33 weeks of gestation was diagnosed with pre-eclampsia with severe features requiring emergent caesarean section. The woman continued to have altered mental status and focal neurologic deficits after delivery. Computerized tomography head imaging demonstrated a subdural collection discovered to be an empyema due to unilateral acute sinusitis of odontogenic origin.
Maintaining a clinical suspicion for acute sinusitis as a cause of headache in a pregnant woman is important for prompt diagnosis and treatment before it develops into a rare intracranial complication.
孕期头痛的发生率为35%。虽然在孕妇群体中排除先兆子痫作为头痛的可能病因很重要，但急性鼻窦炎也应列入鉴别诊断范围，因为其在孕妇中的发生率要高出六倍。未经治疗的疾病可能导致罕见的颅内并发症，如硬膜下积脓。一名21岁女性在妊娠33周时反复头痛，被诊断为伴有严重特征的先兆子痫，需要紧急剖宫产。该女性产后仍有精神状态改变和局灶性神经功能缺损。计算机断层扫描头部成像显示硬膜下积液，经发现是由牙源性单侧急性鼻窦炎引起的积脓。
对孕妇头痛病因保持急性鼻窦炎的临床怀疑，对于在其发展为罕见的颅内并发症之前进行及时诊断和治疗很重要。
