Headache attributed to pre-eclampsia or eclampsia

The ICHD-3 beta criteria for pre-eclampsia/eclampsia-associated headache have high reliability and validity in adolescents since headache symptoms at this age group resemble adult headache. Perpubertal children are not expected physiologically to be pregnant. The symptoms overlap with adult pre-eclampsia or eclampsia. The risk is higher up to age 19 years, so the rate of headache may be higher in that age group as well [69]. Severe vasoconstriction often develops in women with pre-eclampsia, especially when blood pressure is poorly controlled, and can cause brain infarction and hemorrhage. Reversible cerebral vasoconstriction syndrome (RCVS), also referred to as postpartum angiopathy and Call-Fleming syndrome, can develop during the puerperium in the absence of hypertension or other features of pre-eclampsia. Pre-eclampsia, eclampsia, and RCVS can all be complicated by PRES [70].

Since headache may be the presenting symptom of other pregnancy- related complications, criteria D should be changed as follows:

D: not better accounted for by another ICHD-3 diagnosis or other pregnancy-related neurologic co-morbidity.