Zimmermann Julia S M, Fousse Mathias, Juhasz-Böss Ingolf, Radosa Julia C, Solomayer Erich-Franz, Mühl-Benninghaus Ruben
Department of Gynecology, Obstetrics and Reproductive Medicine, University Medical School of Saarland, 66421 Homburg/Saar, Germany.
Department of Neurology, University Medical School of Saarland, 66421 Homburg/Saar, Germany.
J Clin Med. 2023 Mar 13;12(6):2204. doi: 10.3390/jcm12062204.
Headache is a common symptom during pregnancy and in puerperium that requires careful consideration, as it may be caused by a life-threatening condition. Headaches in pregnant women and women in puerperium are classified as primary or secondary; acute, severe and newly diagnosed headaches should prompt further investigation. We aimed to further characterise the demographic features, symptoms, examination findings, and neuroimaging results of cases of headache during pregnancy and in puerperium. All pregnant women or women in postpartum conditions who attended neurological consultations at the emergency department of the clinic for Gynaecology, Obstetrics and Reproductive Medicine of Saarland University/Germany between 2001/2015 and 2012/2019 were enrolled in this retrospective chart review. Data collected from the charts included demographic/pregnancy characteristics, clinical features and imaging findings. Descriptive statistics as well as binary logistic regression were performed. More than 50% of 97 patients had abnormal findings in their neurological examination. Magnetic resonance imaging findings were pathological for almost 20% of patients-indicating conditions such as cerebral venous thrombosis, reversible posterior leukoencephalopathy, brain tumour and intracranial bleeding. The odds of abnormal neuroimaging results were 2.2-times greater among women with abnormal neurological examination findings than among those with normal examination results. In cases of headache during pregnancy and in puerperium, neuroimaging should be indicated early on. Further research is needed to determine which conditions indicate a need for immediate neuroimaging.
头痛是孕期和产褥期的常见症状，需要仔细考量，因为它可能由危及生命的病症引起。孕妇和产褥期女性的头痛分为原发性或继发性；急性、严重且新诊断出的头痛应促使进一步检查。我们旨在进一步描述孕期和产褥期头痛病例的人口统计学特征、症状、检查结果及神经影像学结果。2001年/2015年至2012年/2019年期间，在德国萨尔兰大学妇产科及生殖医学诊所急诊科接受神经科会诊的所有孕妇或产后女性均纳入本回顾性病历审查。从病历中收集的数据包括人口统计学/妊娠特征、临床特征及影像学检查结果。进行了描述性统计以及二元逻辑回归分析。97例患者中超过50%的患者神经科检查有异常发现。近20%患者的磁共振成像结果呈病理性，提示存在脑静脉血栓形成、可逆性后部白质脑病、脑肿瘤及颅内出血等病症。神经科检查结果异常的女性出现异常神经影像学结果的几率是检查结果正常女性的2.2倍。对于孕期和产褥期头痛病例，应尽早进行神经影像学检查。需要进一步研究以确定哪些病症表明需要立即进行神经影像学检查。
