Postpartum Headache

Excerpt

Headaches are a frequent presenting chief complaint in the emergency department, which disproportionally affects women of childbearing age. The incidence of headache increases in the puerperium, triggered by the sharp chemical and social changes surrounding the postpartum period. Data and research on postpartum headaches are skewed towards severe headaches as many patients self-medicate with analgesics in the setting of mild or moderate headaches and never seek medical care. Because the features of many types of postpartum headaches overlap—and headache syndromes can exist concurrently—differentiation of the conditions that present with headaches in the postpartum period may be difficult. The threshold for advanced diagnostic testing and imaging is lower in this population than in those in a comparable age group, highlighting the importance of a detailed history-taking and physical examination with vigilance to the elicitation of red-flag historical features and symptoms and neurological findings, which are often subtle and easily overlooked.