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

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