Meredith Barad, MD
Clinical Assistant Professor,
Department of Anesthesia and Neurology
Stanford University
Sheena Aurora, MD
Clinical Associate Professor,
Department of Neurology
Stanford University
Although a large study has never been conducted, headache is probably the most
frequent complaint in pregnancy. Tension-type headache is probably the most
common headache type noted during pregnancy, and migraine is second.
Initially, let’s talk about some of the ominous headaches which are very rare:
Headaches Due To Cerebral Venous Sinus
Thrombosis (CVT):
This type of headache is a very rare occurrence during
pregnancy although it is the most common secondary
reason to have a headache—which means there is an
identified cause. The overall incidence of CVT is very
low with 3 to 4 cases per million in adults. The cause of
this condition is thought to be due to the hormonal surge
during pregnancy which increases the risk of blood clots.
Some of the early signs of CVT include an increasing
severity of headaches, in other words headaches that
continue to worsen. These headaches may be accompanied by symptoms such as nausea, stroke-like symptoms
(i.e. numbness or weakness on one side of the body, new
visual symptoms, seizures).
The most practical advice for pregnant women is to
become ever more alert to unusual conditions because of
an increased risk of problems with blood clotting. It is
important that pregnant women maintain adequate fluid
intake, particularly during travel. Although the “morning sickness” most evident during the first trimester can
cause dehydration, their fluid intake should be closely
monitored.
Tension-type Headache:
The features of tension-type headache during pregnancy
are similar to those in the general population. These headaches are usually not accompanied by nausea, vomiting,
or light or sound sensitivity—symptoms associated with
migraine. The headaches are usually described as more of
a nuisance. In general, these headaches are not disabling.
The recommended treatment for tension-type headaches
is relaxation exercises, deep breathing, massage, and if
needed, low doses of acetaminophen.
Migraine Headaches:
We encourage patients who have a migraine history to
consider options during the pre-pregnanc