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Postpartum angiopathy with reversible posterior leukoencephalopathy
1Stroke Service, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, 02114, USA. asinghal@partners.org
Archives of Neurology
|March 17, 2004
Summary
Postpartum angiopathy (PPA) and reversible posterior leukoencephalopathy syndrome (RPLS) can coexist. These conditions, affecting cerebral arteries and brain imaging, may be interrelated in postpartum women.
Area of Science:
- Neurology
- Radiology
- Obstetrics
Background:
- Postpartum angiopathy (PPA) is a cerebral vasoconstriction syndrome affecting large and medium cerebral arteries, often leading to ischemic stroke.
- Reversible posterior leukoencephalopathy syndrome (RPLS) is a distinct entity with transient vasogenic edema on brain imaging, linked to small-vessel dysfunction and blood-brain barrier breakdown.
Observation:
- Four women presented with a syndrome overlapping PPA and eclampsia post-pregnancy.
- All experienced severe headaches and hypertension; three had seizures.
- Cerebral imaging revealed reversible narrowing of cerebral arteries and transient nonischemic brain lesions similar to RPLS.
Findings:
- The study reports the coexistence of PPA and RPLS in four patients.
- Extensive tests for cerebral vasculitis were negative in all cases.
- Angiographic findings showed reversible narrowing of cerebral arteries.
Implications:
- The findings suggest a potential interrelationship between RPLS and cerebral vasoconstriction syndromes like PPA.
- This highlights the need for further research into the pathophysiology and management of these postpartum neurological conditions.