[Cerebrovascular disease in pregnancy and puerperium].

UNLABELLED: Cerebrovascular diseases are the main causes of neurological events occurring during pregnancy and puerperium.
METHODS: We retrospectively reviewed the clinical records and imaging scans of females presenting with stroke during pregnancy or puerperium. We selected the cases with abnormal initial CT and/or MRI and a radiological follow-up until stabilization of the neurological condition.
RESULTS: Eleven patients with ages ranging from 21-38 years were found. The hospital admission occurred between the second trimester of pregnancy and the first two weeks after delivery. In six cases there was a clinical setting of preeclampsia/eclampsia (PE/E): five with reversible encephalopathy syndromes (hypertensive-like encephalopathy) and one with a hematoma in a HELLP patient. Three other cases had a clinical setting of hypertension, not fulfilling the PE/E criteria, presented with hemorrhagic infarct in one case and lenticular hematoma in the other two. The other two cases were a subarachnoid hemorrhage in a patient with a middle cerebral aneurysm and a cortical venous infarct in a patient with lateral sinus thrombosis.
CONCLUSION: Hypertension is the major underlying factor in peri-partum stroke. PE/E syndrome is the major leading cause of stroke in the peri-partum and maternal morbidity/mortality. MRI is very useful in evaluating this entity and, may have a positive impact on the management protocol.