MRI Head Without and With IV Contrast There is no relevant literature to support the use of MRI head without and with IV contrast in the initial imaging evaluation of new headache during pregnancy or peripartum period; the recommendation is to avoid administering IV GBCA during pregnancy. MRI Head Without IV Contrast MRI head without IV contrast can be useful in the initial imaging evaluation of new headache during pregnancy or peripartum period. There are multiple etiologies that can cause secondary headaches in pregnant women. For TCH, there is the possibility of arterial pathologies such as aneurysmal SAH or RCVS, especially in the postpartum period (also refer to Variant 1). Structural lesions include intracranial neoplasms and lesions originating from the pituitary gland. Another condition to consider is intracranial hypertension, especially in an obese female (also refer to variant 4). Preeclampsia and eclampsia are diseases of pregnancy that can present with headache and with findings of PRES on neuroimaging [47,49-51]. Brain MRI is the study of choice to evaluate for vasogenic edema due to endothelial dysfunction in PRES. It is best seen on FLAIR and T2-weighted imaging, which is more sensitive for abnormalities in the posterior fossa than head CT, which is abnormal in 45% of patients with PRES. In the setting of headache with new onset seizures, MRI can potentially detect the causative mass/lesion or PRES to support a diagnosis of eclampsia. [49,50]. Lesions originating from the pituitary gland are also readily detectable on MRI [30,49]. MRV Head With IV Contrast There is no relevant literature to support the use of MRV head with IV contrast in the initial imaging evaluation of new headache during pregnancy or peripartum period; the recommendation is to avoid administering IV GBCA during pregnancy.
Headache PCAs. MRI Head Without and With IV Contrast There is no relevant literature to support the use of MRI head without and with IV contrast in the initial imaging evaluation of new headache during pregnancy or peripartum period; the recommendation is to avoid administering IV GBCA during pregnancy. MRI Head Without IV Contrast MRI head without IV contrast can be useful in the initial imaging evaluation of new headache during pregnancy or peripartum period. There are multiple etiologies that can cause secondary headaches in pregnant women. For TCH, there is the possibility of arterial pathologies such as aneurysmal SAH or RCVS, especially in the postpartum period (also refer to Variant 1). Structural lesions include intracranial neoplasms and lesions originating from the pituitary gland. Another condition to consider is intracranial hypertension, especially in an obese female (also refer to variant 4). Preeclampsia and eclampsia are diseases of pregnancy that can present with headache and with findings of PRES on neuroimaging [47,49-51]. Brain MRI is the study of choice to evaluate for vasogenic edema due to endothelial dysfunction in PRES. It is best seen on FLAIR and T2-weighted imaging, which is more sensitive for abnormalities in the posterior fossa than head CT, which is abnormal in 45% of patients with PRES. In the setting of headache with new onset seizures, MRI can potentially detect the causative mass/lesion or PRES to support a diagnosis of eclampsia. [49,50]. Lesions originating from the pituitary gland are also readily detectable on MRI [30,49]. MRV Head With IV Contrast There is no relevant literature to support the use of MRV head with IV contrast in the initial imaging evaluation of new headache during pregnancy or peripartum period; the recommendation is to avoid administering IV GBCA during pregnancy.