ABSTRACT
Headaches continue to occur when a woman becomes pregnant, but a different emphasis is necessary. Migraine, tension-type headache, and other primary headaches occur during pregnancy, as do the conditions that mimic them: vasculitis, brain tumor, and occipital arteriovenous malformations (AVM). Diagnostic testing serves to exclude organic causes of headache, to confirm the diagnosis, and to establish a baseline before treatment. Head computed tomography (CT) is relatively safe during pregnancy and is the study of choice for head trauma and possible nontrau-matic subarachnoid, subdural, or intraparenchymal hemorrhage. The cause of headache in the postpartum period is postdural puncture headache owing to a spinal anesthetic or an accidental dural puncture. Increased frequency and severity of migraine associated with nausea and vomiting may justify the use of preventive medication. If a woman inadvertently takes a drug while she is pregnant or becomes pregnant while on medication, it is important to determine the dose, timing, and duration of the exposure(s).
