Headaches in pregnant women

A review of headaches during pregnancy shows that there are 85 different types of headaches a pregnant woman can have, some of which may be serious.

Most headaches in pregnancy and the postnatal period are benign, but healthcare professionals must be alert to the rarer and more severe causes of headaches, suggests a new review published today (23 May) in The Obstetrician & Gynaecologist (TOG).

The review looks at common causes for headaches during pregnancy and the postnatal period, possible conditions that may be associated with headaches and how healthcare professionals should manage the care of the woman appropriately.

There are 85 different types of headache. Approximately 90% of headaches in pregnancy are migraine or tension-type headaches. However, pregnancy can lead to an increased risk of certain secondary headaches, a headache caused by an underlying health condition, states the review.

The review states that most headaches in pregnancy are benign but in some cases can be more serious. According to the Confidential Enquiries into Maternal Deaths in the United Kingdom 2006 -- 2008 report[i], neurological conditions were the third most common cause of death, considering both direct and indirect causes. The authors of the review therefore emphasize the need for all medical staff to be well trained to take a full history and examination, make a provisional differential diagnosis and know when to seek neurological expertise.

Migraine is a common form of headache; the condition is more common in women, with the highest prevalence rates during the childbearing years. The review states that pregnancy leads to a reduction in the frequency and severity of attacks of migraines without aura, also known as a common migraine. However, women who do experience migraines have a more than two-fold increased risk of pre-eclampsia than those who do not. Women therefore need to be aware to consult a healthcare professional if their headache is different from their usual migraine, highlights the review.

Another condition associated with a headache in pregnancy is idiopathic intracranial hypertension, a build up of high pressure inside the skull, a rare condition but more prevalent in obese women of childbearing age. The condition may present for the first time in pregnancy and pre-existing disease tends to worsen in pregnancy. It can be fatal if it is not treated promptly as a medical emergency.

Pregnancy is also a recognized risk factor for cerebral venous thrombosis (CVT), the presence of a blood clot in the dural venous sinuses, which drain blood from the brain. Caesarean section, systematic infection, vomiting and anemia increase the risk and headache is the most frequently (80 -- 90%) occurring symptom in CVT and often the first symptom reported by patients.

The review also discusses imaging and advises that imaging of the brain should never be withheld because a woman is pregnant and women should be reassured that imaging is safe.

Kirsty Revell, Specialist Registrar, Obstetrics and Gynaecology at the Princess Anne Hospital, Southampton and co-author of the review said: "Headaches are common in life and in pregnancy. Most headaches are benign, for example migraine or tension headaches, but some headache types can be more serious and an indication that something is seriously wrong.

"It is vital that both GPs and obstetricians are aware of the signs and symptoms associated with these conditions and know when to seek advice from a specialist."

Jason Waugh, TOG Editor-in-chief added: "Many women experience headaches during pregnancy and the postpartum period and most are managed by women themselves or within primary care.

"Women presenting with headaches in pregnancy and the postnatal period may be at home, on a maternity ward, in an antenatal clinic, at a tertiary referral centre or in an emergency department. All medical staff should be aware of the symptoms, signs and appropriate response to the rarer and more severe cause

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Headaches in children

This article gives a lot of information on headaches in children.

Why do children get headaches?

Headaches in children are common and usually not serious.  Causes include migraines, stress and tension headaches, trauma, sinus disease and eye problems.  Certain foods with nitrate preservatives and MSG (monosodium glutamate) can trigger headaches.  Brain tumors in children as a cause for headaches are extremely rare, and are usually associated with additional neurologic symptoms such as dizziness and lack of coordination.

How are children with headaches evaluated?

Children should have a thorough physical examination with a pediatrician.  He/she may order additional tests or refer to a neurologist.  It is helpful to keep a headache diary so that possible triggers (certain foods or activities) can be discovered.

If no obvious medical cause for the headaches is found by the pediatrician, a referral to an ophthalmologist is required to perform a complete eye exam.  The entire visual system should be examined.  This includes refractive error (the need for glasses), eye alignment, and binocularity (the ability to use both eyes together).  During this examination the pupils should be dilated.

 How do eye problems cause headaches in children?

Hyperopia (farsightedness) requires extra effort to focus clearly while reading.  This can sometimes lead to fatigue and headache.  Glasses can reduce the effort required to see clearly at near and improve the headache.

The decreased ability to pull the eyes toward each other when viewing near objects (convergence), particularly while reading, may cause headaches.  This is called convergence insufficiency, and symptoms include the doubling of images or words, blurred vision, fatigue, and headaches which worsen with prolonged reading.  Glasses are sometimes prescribed.  At home eye exercises, sometimes with the help of computer software, can help treat convergence insufficiency.  Expensive in office eye exercises are rarely indicated.

 Acute infections and inflammatory diseases of the eyes can cause headaches.  These problems are often accompanied by redness of the eye and/or eyelid and light sensitivity (photophobia).  Acute glaucoma can cause headaches, but rarely affects children.  A complete exam by an ophthalmologist can rule out these conditions.

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Study shows that more stress means more headaches

A study shows that having more stress in your life means you get more headaches.

A new study provides evidence for what many people who experience headache have long suspected—having more stress in your life leads to more headaches. The study released today will be presented at the American Academy of Neurology's 66th Annual Meeting in Philadelphia, April 26 to May 3, 2014.

For the study, 5,159 people age 21 to 71 in the general population were surveyed about their stress levels and headaches four times a year for two years. Participants stated how many headaches they had per month and rated their stress level on a scale of zero to 100.

A total of 31 percent of the participants had tension-type headache, 14 percent had migraine, 11 percent had migraine combined with tension-type headache and for 17 percent the headache type was not classified. Those with tension-type headache rated their stress at an average of 52 out of 100. For migraine, it was 62 out of 100 and 59 for those with migraine and tension-type headache.

For each type of headache, an increase in stress was associated with an increase in the number of headaches per month. For those with tension headache, an increase of 10 points on the stress scale was associated with a 6.3-percent increase in the number of headache days per month. For migraine, the number of headache days per month went up by 4.3 percent, and 4 percent for those with migraine and tension headache. The results were adjusted to account for factors that could affect the number of headaches, such as drinking, smoking and frequent use of headache drugs.

"These results show that this is a problem for everyone who suffers from headaches and emphasize the importance of stress management approaches for people with migraine and those who treat them," said study author Sara H. Schramm, MD, of University Hospital of University Duisburg-Essen in Germany. "The results add weight to the concept that stress can be a factor contributing to the onset of headache disorders, that it accelerates the progression to chronic headache, exacerbates headache episodes, and that the headache experience itself can serve as a stressor."

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Stress leads to frequent headaches and migraines

Research shows that stress could result in frequent headaches and migraines.

New research lends evidence to the commonly held belief that stress leads to headaches.

Researchers analyzed data of 5,519 participants aged 21-71 years, and found that an increase in stress was associated with an increase in the number of headaches participants suffered each month. The findings were presented at the American Academy of Neurology’s Annual Meeting in Philadelphia on Wednesday.

Survey participants reported their stress levels and headaches quarterly from 2010-2012, as part of the German Headache Consortium Study. A total of 31 percent had tension-type headaches, 14 percent had migraine and 11 percent had migraine combined with tension-type headache. Participants with tension-type headaches rated their stress at an average of 52 out of 100, while migraine rated at 62 out of 100. Those with migraine and tension-type headaches rated at 59 out of 100.

“Tension-type headache (TTH) and migraine are the most common primary headache disorders, affecting up to 80 percent of the general population— that’s why we choose to look at both,” study author Dr. Sara H. Schramm, of University Hospital at University Duisburg-Essen in Germany wrote in an email to FoxNews.com

The data showed that, for each type of headache, an increase on the stress scale was tied to an increase in the number of headaches per month. An increase of 10 stress points was associated with a 6.3 percent headache increase for people with TTH, 4.3 percent increase for migraine and 4 percent increase for migraine and tension headache.

It’s the first study to show that  stress has an influence on headaches, according to the researchers.

“To the best of our knowledge, prospective population-based studies evaluating the effect of stress on headache frequency, with regard to particular subtypes of primary headaches, have not been performed until now. In a prospective study we can confirm … what we always hear from our patients,” Schramm said.

TTH and migraine are characterized by different symptoms – TTH by mild-to-moderate headache intensity and dull, tightening pain and migraine by unilateral, severe pulsating headache accompanied by nausea, vomiting and light and sound sensitivity.  It’s not known if they have similar or different biological mechanisms in reaction to stress.

Researchers said their findings show the importance of stress management for people who suffer TTH or migraine.

“Psychological treatment, especially coaching for stress, is important,” Schramm said.

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Link Between Women and Migraines

This article discusses the basics of migraine headaches and why there is such a strong link between women and migraines.

THE fact that three out of every four persons struck with a migraine are women has resulted in this condition being considered the most common disabling problem faced by women globally that results in them having to see a doctor.

Here are some of the most common questions women ask about migraines.

What are migraines and who gets them?

It is a severe type of headache that is accompanied by other changes apart from just pain. For example, some persons might feel nauseous, some persons may actually vomit and, some persons may have visual changes like blurred vision or flashing lights. Some persons also have numbness on one side of their body.

While the causes of migraines are still not known, researchers say that those with a family history of migraine are more likely to have it. This is also the case for those who have a history of depression, anxiety, stroke or high blood pressure.

Why do more women than men suffer from migraines?

Researchers have noted that migraines mostly affect women who are between the ages of 15 and 55 years old. However, there are no definitive reasons as to why. "It could be hormonal, but I couldn't give you a good explanation for that," said Dr Campbell.

What are some of the things that trigger migraines?

Food allergies, bright lights, loud nights, strong odours, weather changes, hormonal changes during menstruation, lack of or too much sleep, stress and anxiety, caffeine, skipped meals, alcohol can be triggers.

Food additives like dyes are usually important triggers. For some people it's chocolate, for others, citrus. MSG is a culprit too.

What is the difference between a migraine headache and a bad tension headache?

There are several other types of headaches besides migraines. There is the tension headache, for example, which is less severe and debilitating.

"For a tension headache, the presentation is going to be different. That has to be a sort of a clinical diagnosis, but usually with a tension headache, the headaches come as a result of spasm of the muscles in the head," explained Dr Campbell. "But to determine which is which, one ought to be examined by a physician."

What can I do to ease my migraine pain?

While there is no cure, there are certain medications that can help to ease the pain. It is always important to be diagnosed by a doctor who can prescribe these treatments. However, magnesium, fish oil and guinea hen weed are generally helpful. The doctor said she personally uses guinea hen weed.

"I get the root of the guinea hen weed, wash it, chop it up, throw rum on it, and if I feel a headache coming on, I inhale it," she said.

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