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Abstract Details

Headache Characteristics in the Post-partum of Patients with Hypertensive Complications During Pregnancy.
Headache
P15 - Poster Session 15 (12:00 PM-1:00 PM)
7-007
Describe the headache phenotypes in the puerperium of patients that had had preeclampsia, eclampsia and cerebral reversible vasoconstriction syndrome.

Headache is common in the puerperium. It can be precipitated, worsened or caused by many factors. Physiologic changes or peripartum procedures can have a role. Differential diagnosis is challenging, since there can be primary or secondary headaches. It has been estimated that 75% are primary, specially migraine. We studied the neurological profile of our patients with hypertensive complications and the data about headache are presented.
This is a prospective study that included patients with pregnancy and arterial hypertension that were seen in the Obstetrics service in the period November 2018 – August 2019. They were studied clinically with a complete neurological evaluation including MoCA, surface EEG and MRI within the first 72 hours after the diagnosis. There was a follow-up three months later.
42 patients were included: preclampsia 28(66.6%), eclampsia 12(28.5%) and HELLP syndrome 2(4.7%); mean age 22.8, first pregnancy 63%, mean gestational age 37.2 weeks.  The main complain during hospitalization was headache in 28 (66.6%). It was throbbing in half, intensity 7.8 – 10/10 VAS; photophobia 38% of preeclamptic and nausea in 50% of eclamptic; abrupt onset in 50% of preeclamptic and progressive in 2/3 of eclamptic and 83% of CRVS. Follow up was done in 16 patients: 13 preeclamptic of which 10 (81.2%) still had headache, as well as 3 (66%) eclamptic and 2 (50%) with RCVS. Final diagnosis according to ICHD-3 were: 2 migraine w/oa, 5 probable migraine, 1 tension-type headache, 3 probable tension-type and 1 primary thunderclap headache.
As far as we know, this is the first prospective study of headache characteristics in patients with hypertensive complications of pregnancy. Our results suggest a that hypertensive conditions during pregnancy can be a trigger of primary headaches thereafter. 
Authors/Disclosures

PRESENTER 		No disclosure on file
Alejandro R. Marfil-Rivera, MD (Hospital Universitario, Servicio De Neurologia) Dr. Marfil-Rivera has nothing to disclose.
Luis Fernandez (Neurology, University Hospital UANL) No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Juan F. Gongora Rivera, MD, MD, MSc, PhD (Neurology and Stroke Unit, University Hospital UANL) Dr. Gongora Rivera has nothing to disclose.