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Cerebrovascular disorders complicating pregnancy.
Continuum (Minneapolis, Minn.)
|February 5, 2014
Summary
Pregnancy and postpartum strokes, though uncommon, are serious disabling complications. This review covers physiologic changes, epidemiology, diagnosis, and treatment for pregnancy-related strokes, including preeclampsia-eclampsia connections.
Area of Science:
- Neurology
- Obstetrics
- Vascular Medicine
Background:
- Pregnancy involves significant physiologic changes that alter stroke risk.
- Cerebrovascular complications during pregnancy and the puerperium, while uncommon, represent a major cause of serious disability.
Observation:
- This review updates understanding of preeclampsia/eclampsia, posterior reversible encephalopathy syndrome (PRES), and reversible cerebral vasoconstriction syndrome (RCVS), highlighting shared pathogenesis.
- Recent data on the epidemiology, diagnosis, and management of ischemic and hemorrhagic stroke in pregnancy are discussed.
Findings:
- Stroke remains the most common seriously disabling complication of pregnancy.
- Preeclampsia/eclampsia is linked to PRES and RCVS, suggesting common underlying mechanisms.
- Recommendations for thrombolytic and revascularization therapies in pregnancy-related strokes are provided.
Implications:
- Optimal evaluation and management strategies are crucial for maternal and fetal safety.
- Understanding the pathophysiology of pregnancy-related strokes is key to improving outcomes.
- Further research is needed to refine treatment protocols for cerebrovascular events during pregnancy and postpartum.
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