Beyond postdural puncture headache

Headaches are one of the most common neurological complaints after childbirth, occurring in nearly 40% of women in the early postpartum period. While many are benign primary headaches such as migraine or tension-type headache, a significant proportion are secondary headaches caused by potentially life-threatening conditions. The article highlights rare but dangerous postpartum headache syndromes that may mimic postdural puncture headache or preeclampsia, including cerebral venous sinus thrombosis, posterior reversible encephalopathy syndrome, and reversible cerebral vasoconstrictive syndrome. Diagnosis is often delayed due to postpartum fatigue, hormonal changes, sleep deprivation, and stress. Early recognition of these conditions is critical, as appropriate treatment including anticoagulation, blood pressure control, and specific therapies typically leads to complete neurological recovery.