How can we best use diagnostic brain imaging in pregnant women with severe headache? | MDedge

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How can we best use diagnostic brain imaging in pregnant women with severe headache?

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John T. Repke, MD

Citation: Raffaelli B, Neeb L, Israel-Willner, et al. Brain imaging in pregnant women with acute headache. J Neurol. 2018;265(8):1836–1843.

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Dr. Repke is Professor Emeritus, Obstetrics and Gynecology, Penn State University College of Medicine, Hershey, Pennsylvania.

The author reports no financial relationships relevant to this video.

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Author(s)

John T. Repke, MD

Author(s)

John T. Repke, MD

Author and Disclosure Information

Dr. Repke is Professor Emeritus, Obstetrics and Gynecology, Penn State University College of Medicine, Hershey, Pennsylvania.

The author reports no financial relationships relevant to this video.

Author and Disclosure Information

Dr. Repke is Professor Emeritus, Obstetrics and Gynecology, Penn State University College of Medicine, Hershey, Pennsylvania.

The author reports no financial relationships relevant to this video.

Citation: Raffaelli B, Neeb L, Israel-Willner, et al. Brain imaging in pregnant women with acute headache. J Neurol. 2018;265(8):1836–1843.

Citation: Raffaelli B, Neeb L, Israel-Willner, et al. Brain imaging in pregnant women with acute headache. J Neurol. 2018;265(8):1836–1843.

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How can we best use diagnostic brain imaging in pregnant women with severe headache?

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WHAT DOES THIS MEAN FOR PRACTICE?

Acute, severe headache in pregnancy needs immediate attention when it includes:
- seizures
- altered sensorium, or
- loss of consciousness
An appropriate threshold utilizing history and clinical diagnosis must be set for obtaining neurologic consultation and for the consultant to obtain imaging
Brain scans can identify symptomatic pathologic results (27.6% in this study)
Theoretical concerns about imaging call for the OB to be very involved in evaluation and management
OB and neurologist should discuss risks and benefits of imaging throughout care

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