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[Pregnancy, puerperium and cerebrovascular disease]
M M Fukujima1, R M Oliveira, J C Shimazaki
1Escola Paulista de Medicina, Universidade Federal de São Paulo.
Insights
Cerebrovascular disease in pregnancy and postpartum is rare but serious. This study highlights Chagas disease as a key potential cause in Brazil, alongside pre-eclampsia and other risk factors in young women.
Area of Science:
- Neurology
- Cardiology
- Infectious Diseases
Context:
- Cerebrovascular disease (CVD) during pregnancy and the postpartum period is uncommon but carries significant risks.
- Understanding the specific etiologies of CVD in young women is crucial for timely diagnosis and management.
- This study focuses on a cohort of patients in Brazil, a region where certain infectious diseases are prevalent.
Purpose:
- To investigate the underlying causes of cerebrovascular events in pregnant and postpartum women.
- To identify potential risk factors and associations, including infectious diseases and autoimmune conditions.
- To emphasize the importance of thorough clinical evaluation for CVD in young individuals.
Summary:
- Six patients experiencing cerebrovascular disease during pregnancy or puerperium were analyzed.
- Causes included hemorrhagic stroke (pre-eclampsia), ischemic stroke (Chagas' disease association), and cerebral venous thrombosis (smoking, oral contraceptive use).
- Three patients with ischemic stroke tested positive for Chagas' disease, with two exhibiting clinical cardiopathy.
Impact:
- Highlights the need for considering infectious etiologies like Chagas' disease in young patients with CVD, particularly in endemic regions.
- Underscores the importance of investigating common causes of stroke in young populations.
- Informs clinical practice regarding risk assessment and diagnostic workup for cerebrovascular events in pregnant and postpartum women.
Abstract:
Six patients who presented cerebrovascular disease during puerperium or pregnancy were studied. One of them presented hemorrhagic stroke caused by intracerebral bleeding due to pre-eclampsia. Three patients presented ischemic stroke, they all had positive serologic reactions for Chagas' disease, but only two of them had clinical cardiopathy; one of these patients had anticardiolipin antibody. The other two patients presented cerebral venous thrombosis of sagittal sinus. Both were smokers and one of them used oral contraceptive. We emphasize the importance of clinical investigation to seek for the common causes of cerebrovascular disease in young people, with special attention to Chagas disease in Brazil.