Expert Commentary

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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