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Pregnancy and postpartum significantly increase stroke risk, particularly ischemic stroke after cesarean section. Early recognition and aggressive monitoring are crucial for high-risk mothers.

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Area of Science:

  • Neurology
  • Obstetrics
  • Vascular Medicine

Background:

  • Pregnancy and the postpartum period are associated with an elevated risk of stroke, contributing to maternal morbidity and mortality.
  • Physiological hemodynamic shifts and increased coagulability during pregnancy heighten stroke risk.
  • Pregnancy-related strokes can manifest as either hemorrhagic or ischemic types.

Observation:

  • A rare case of postpartum ischemic stroke is presented in a 25-year-old female, 10 days after a cesarean section.
  • The patient presented with acute right-sided hemiparesis and sensory deficits.
  • Head MRI revealed findings consistent with acute ischemic infarction in the left parietal lobe, with a suggestion of minor hemorrhage.

Findings:

  • Diffusion-weighted imaging (DW1) and apparent diffusion coefficient (ADC) maps indicated restricted diffusion, characteristic of acute ischemic stroke.
  • Susceptibility-weighted imaging (SW1) showed a small blooming artifact, potentially indicating a hemorrhagic component.
  • Standard MRI sequences (T1, T2, FLAIR) demonstrated abnormalities consistent with infarction.

Implications:

  • The findings underscore the increased risk of ischemic stroke in the immediate postpartum period, especially following cesarean delivery.
  • Clinicians must maintain a high index of suspicion for stroke in postpartum women.
  • Aggressive monitoring and early identification of high-risk individuals in the postpartum period are essential for improved maternal outcomes.