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      Don’t Forget Rare Causes of Postpartum Headache! Cases Report and Literature Review

      case-report

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          Abstract

          Headache is a common finding in the postpartum period, caused by a spectrum of different conditions. Most headaches in the postpartum period are self-limiting and benign in etiology, but there are some potentially serious causes to be considered. We disclose two cases of postpartum headache, initially considered as post-dural puncture headache (PDPH), that evolved into a harmful condition and showed that an expanded differential diagnosis for headache in the postpartum is mandatory, requiring a high level of attention from health professionals. In fact, a careful examination of the medical history, physical examination, and the recognition for the need for early neuroradiological imaging should increase diagnostic accuracy.

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          The incidence and prevalence of cluster headache: a meta-analysis of population-based studies.

          M Fischera, I Gralow, Brandon Evers … (2008)
          Cluster headache is a trigemino-autonomic cephalgia with a low prevalence. Several population-based studies on its prevalence and incidence have been performed, but with different methodology resulting in different figures. We analysed all available population-based epidemiological studies on cluster headache and compared the data in a meta-analysis. The pooled data showed a lifetime prevalence of 124 per 100,000 [confidence interval (CI) 101, 151] and a 1-year prevalence of 53 per 100,000 (CI 26, 95). The overall sex ratio was 4.3 (male to female), it was higher in chronic cluster headache (15.0) compared with episodic cluster headache (3.8). The ratio of episodic vs. chronic cluster headache was 6.0. Our analysis revealed a relatively stable lifetime prevalence, which suggests that about one in 1000 people suffers from cluster headache, the prevalence being independent of the region of the population study. The sex ratio (male to female) is higher than published in several patient-based epidemiological studies.
          Article 0 comments Cited 114 times – based on 0 reviews     Review now
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            Review of the management of pneumocephalus

            Carlos B. Dabdoub, Gueider Salas, Elisabeth Silveira … (2015)
            Background: Pneumocephalus (PNC) is the presence of air in the intracranial cavity. The most frequent cause is trauma, but there are many other etiological factors, such as surgical procedures. PNC with compression of frontal lobes and the widening of the interhemispheric space between the tips of the frontal lobes is a characteristic radiological finding of the “Mount Fuji sign.” In addition to presenting our own case, we reviewed the most relevant clinical features, diagnostic methods, and conservative management for this condition. Case Description: A 74-year-old male was diagnosed with meningioma of olfactory groove several years ago. After no improvement, surgery of the left frontal craniotomy keyhole type was conducted. A computed tomography (CT) scan of the skull performed 24 h later showed a neuroimaging that it is described as the silhouette of Mount Fuji. The treatment was conservative and used continuous oxygen for 5 days. Control CT scan demonstrated reduction of the intracranial air with normal brain parenchyma. Conclusion: The review of the literature, we did not find any cases of tension pneumocephalus documented previously through a supraorbital keyhole approach. There are a few cases reported of patients with Mount Fuji signs that do not require surgical procedures. The conservative treatment in our report leads to clinical and radiological improvement as well as a reduction in hospitalization time.
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              Cerebral venous sinus thrombosis in pregnancy and puerperium: A pooled, systematic review.

              Ahmed Kashkoush, Henry Ma, Nitin Agarwal … (2017)
              Pregnancy and puerperium are risk factors for cerebral venous sinus thrombosis (CVST); however studies describing diagnosis and management in this population are limited. The objective of this study was to amalgamate published case reports and series regarding diagnosis and management of CVST in pregnancy and puerperium. Searches of PubMed and the Cochrane library were performed using search terms "pregnancy"/"puerperium" and "sinus occlusion"/"sinus thrombosis". Studies were included in our pooled analysis if they included individual patient symptoms, management approach and follow-up condition. Multivariate regression was utilized to assess the effect of non-modifiable factors on excellent outcome (mRS 0). Sixty-six patients were included. Mean duration of symptom onset to diagnosis was 5.9days (95% CI 4.2-7.6). Clot involvement of the superior sagittal sinus was seen in 67% of cases, the transverse/sigmoid in 64% and of the deep venous system in 15% of cases. Management approaches included anticoagulation (91% of patients), IA (intra-arterial) thrombolysis alone (26%), and IA thrombectomy with IA thrombolysis (8%). Fifty-nine percent of patients were mRS 0 at follow-up; 94% were mRS 0-2. Presentation with headache alone was associated with excellent outcome on multivariate analysis (p=0.04); coma/obtundation predicted against excellent outcome (p=0.03). As compared to IA thrombolysis alone, patients undergoing IA thrombolysis with IA thrombectomy demonstrated a trend toward better outcome (p=0.10).
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                Author and article information

                Contributors
                Edgaras Stankevičius: Role: Academic Editor
                Janey Prodoehl: Role: Academic Editor
                Journal
                Journal ID (nlm-ta): Medicina (Kaunas)
                Journal ID (iso-abbrev): Medicina (Kaunas)
                Journal ID (publisher-id): medicina
                Title: Medicina
                Publisher: MDPI
                ISSN (Print): 1010-660X
                ISSN (Electronic): 1648-9144
                Publication date (Electronic): 13 April 2021
                Publication date Collection: April 2021
                Volume: 57
                Issue: 4
                Electronic Location Identifier: 376
                Affiliations
                [1 ]Section of Legal Medicine, S. Chiara Hospital, University of Pisa, via Roma 55, 56126 Pisa, Italy; marco.dipaolo@ 123456unipi.it (M.D.P.); simone.pierotti@ 123456libero.it (S.P.); alicechiara812@ 123456gmail.com (A.C.M.); emanuela.turillazzi@ 123456unipi.it (E.T.)
                [2 ]Section of Anesthesiology, Department of Surgical, Medical, Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy; ornellamangia87@ 123456gmail.com
                [3 ]Section of Maternal and Child Anesthesia and Resuscitation and Santa Chiara, Department of Anesthesia and Resuscitation, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy; bafpesetti@ 123456inwind.it
                [4 ]Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy; massimiliano.dellaquila@ 123456uniroma1.it
                [5 ]Fetal Medicine Unit, Di Venere Hospital, 70121 Bari, Italy; angela.defilippis@ 123456hotmail.it
                Author notes
                [* ]Correspondence: aniellomaiese@ 123456msn.com ; Tel.: +39-389-11-70-401
                Author information
                https://orcid.org/0000-0001-8761-4213
                https://orcid.org/0000-0002-2664-028X
                https://orcid.org/0000-0002-8164-9658
                Article
                Publisher ID: medicina-57-00376
                DOI: 10.3390/medicina57040376
                PMC ID: 8069772
                SO-VID: 789136b9-afaf-45b5-a6fd-ba7454ceff4e
                Copyright © © 2021 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 12 February 2021
                Date accepted : 12 April 2021
                Categories
                Subject: Case Report

                Keywords: post-dural puncture,magnetic resonance imaging,brain,pre-eclampsia/eclampsia,migraines
                Data availability:
                Keywords: post-dural puncture, magnetic resonance imaging, brain, pre-eclampsia/eclampsia, migraines

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