Which finding would favor stroke over a benign headache in pregnancy?

Which finding would favor stroke over a benign headache in pregnancy?

• A. New focal neurologic signs such as facial droop or arm weakness
• B. Headache improves with sleep
• C. Runny nose and sneezing
• D. Nausea without neuro signs

Answer: (A)

The key clue is the presence of a new focal neurologic deficit. New signs like facial droop or unilateral arm weakness point to a cerebrovascular event affecting brain function, which is what stroke does. Benign headaches in pregnancy—such as migraine without new neuro signs or tension-type headaches—typically don’t produce fresh focal deficits and may even improve with rest or sleep. The other options describe symptoms that can occur with non-stroke conditions (sleep-related improvement, allergic symptoms, or nausea in pregnancy) and don’t signal an acute vascular problem. Therefore, new focal neurologic signs are the best finding to favor stroke and would necessitate urgent evaluation and imaging.

The key clue is the presence of a new focal neurologic deficit. New signs like facial droop or unilateral arm weakness point to a cerebrovascular event affecting brain function, which is what stroke does. Benign headaches in pregnancy—such as migraine without new neuro signs or tension-type headaches—typically don’t produce fresh focal deficits and may even improve with rest or sleep. The other options describe symptoms that can occur with non-stroke conditions (sleep-related improvement, allergic symptoms, or nausea in pregnancy) and don’t signal an acute vascular problem. Therefore, new focal neurologic signs are the best finding to favor stroke and would necessitate urgent evaluation and imaging.