Two young women with chronic daily headache and cognitive impairment: Why we need to ask about headache in the postpartum period

Jennifer L. Beams, Todd D. Rozen

Research output: Contribution to journalReview article

Abstract

Headache, which has a variety of causes, is a common and disabling complaint following childbirth. An important aetiology not to be missed is headache from epidural spinal anaesthesia, known as postdural puncture headache (PDPH), which has been reported in upwards of 85% of pregnant women and is a manifestation of intracranial hypotension from leakage of cerebrospinal (CSF) fluid through a dural tear. The common presenting symptom of PDPH is head pain occurring when a patient is in an upright position that resolves with recumbency. Other neurological issues associated with intracranial hypotension can include cranial nerve palsies, encephalopathy and Parkinsonism. We present two cases of persistent PDPH after pregnancy with secondary cognitive impairment. A review of the clinical manifestations, neuroimaging findings and treatment for PDPH will be presented. Better recognition of this disorder by obstetricians, physicians and anaesthetics will help to reduce the considerable morbidity this syndrome can produce in young mothers.

Original languageEnglish (US)
Pages (from-to)83-87
Number of pages5
JournalObstetric Medicine
Volume6
Issue number2
DOIs
StatePublished - 2013

Keywords

  • CSF leak
  • Chronic daily headache
  • Epidural
  • Headache
  • Intracranial hypotension

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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