Lina Bergman1,2, Pablo Torres-Vergara3,4, Jeffrey Penny5, Johan Wikström6, Maria Nelander7, Jose Leon4,8, Mary Tolcher7, James M Roberts9, Anna-Karin Wikström7, Carlos Escudero10,11. 1. Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. lina.bergman@kbh.uu.se. 2. Center for Clinical Research Dalarna, Falun, Uppsala, Sweden. lina.bergman@kbh.uu.se. 3. Pharmacy Department, Faculty of Pharmacy, Universidad de Concepción, Concepción, Chile. 4. Group of Research and Innovation in Vascular Health (GRIVAS Health), Chillán, Chile. 5. Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK. 6. Department of Radiology, Uppsala University, Uppsala, Sweden. 7. Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. 8. Vascular Physiology Laboratory, Group of Investigation in Tumor Angiogenesis, (LFV-GIANT), Department of Basic Sciences, Faculty of Sciences, Universidad del Bío-Bío, Chillán, Chile. 9. Magee Womens Research Institute, Dept of Obstetrics Gynecology and Reproductive Sciences, Epidemiology and Clinical and Translational Research, University of Pittsburgh, Pittsburgh, PA, USA. 10. Group of Research and Innovation in Vascular Health (GRIVAS Health), Chillán, Chile. cescudero@ubiobio.cl. 11. Vascular Physiology Laboratory, Group of Investigation in Tumor Angiogenesis, (LFV-GIANT), Department of Basic Sciences, Faculty of Sciences, Universidad del Bío-Bío, Chillán, Chile. cescudero@ubiobio.cl.
Abstract
PURPOSE OF REVIEW: To provide insight into the mechanisms underlying cerebral pathophysiology and to highlight possible methods for evaluation, screening, and surveillance of cerebral complications in preeclampsia. RECENT FINDINGS: The pathophysiology of eclampsia remains enigmatic. Animal studies show that the cerebral circulation in pregnancy and preeclampsia might be affected with increased permeability over the blood-brain barrier and altered cerebral blood flow due to impaired cerebral autoregulation. The increased blood pressure cannot be the only underlying cause of eclampsia and cerebral edema, since some cases of eclampsia arise without simultaneous hypertension. Findings from animal studies need to be confirmed in human tissues. Evaluation of brain alterations in preeclampsia and eclampsia is challenging and demands a multidisciplinary collaboration, since no single method can accurately and fully describe how preeclampsia affects the brain. Cerebral complications of preeclampsia are significant factors in maternal morbidity and mortality worldwide. No single method can accurately describe the full picture of how preeclampsia affects the brain vasculature and parenchyma. We recommend an international and multidisciplinary effort not only to overcome the issue of limited sample availability but also to optimize the quality of research.
PURPOSE OF REVIEW: To provide insight into the mechanisms underlying cerebral pathophysiology and to highlight possible methods for evaluation, screening, and surveillance of cerebral complications in preeclampsia. RECENT FINDINGS: The pathophysiology of eclampsia remains enigmatic. Animal studies show that the cerebral circulation in pregnancy and preeclampsia might be affected with increased permeability over the blood-brain barrier and altered cerebral blood flow due to impaired cerebral autoregulation. The increased blood pressure cannot be the only underlying cause of eclampsia and cerebral edema, since some cases of eclampsia arise without simultaneous hypertension. Findings from animal studies need to be confirmed in human tissues. Evaluation of brain alterations in preeclampsia and eclampsia is challenging and demands a multidisciplinary collaboration, since no single method can accurately and fully describe how preeclampsia affects the brain. Cerebral complications of preeclampsia are significant factors in maternal morbidity and mortality worldwide. No single method can accurately describe the full picture of how preeclampsia affects the brain vasculature and parenchyma. We recommend an international and multidisciplinary effort not only to overcome the issue of limited sample availability but also to optimize the quality of research.
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