Cerebrovascular Accidents Related with Pregnancy

Abstract

Objectives: Cerebrovascular accidents are rarely encountered in pregnancy and puerperium, but these complications may lead to maternal death. We aimed to investigate in which period of pregnancy the cerebrovascular accidents take place, their etiology, typing and features of localizations, clinical findings and recovery rates.Methods: Nineteen pregnant or postpartum cases who admitte d to Department of Neurology, Faculty of Medicine of lnonu University, between the dates March 1999-March 2004, with the diagnosis of ischemic and hemorrhagic cerebrovascular accidents, subarachnoid hemorrhage and intracranial venous thrombosis were evaluated.Results: Nine ischemic, 5 hemorrhagic cerebrovascular accidents, 3 subarachnoid hemorrhage, 2 intracranial venous thrombosis cases were detected. Eight of these cases were in puerperium. Most frequent reasons of ischemic and hemorrhagic cerebrovascular accidents were valvular heart disease and eclampsia respectively. Localizations of lesions were medial cerebral artery in 7 cases, basal ganglia in 5 cases, occipital in 1 case and pons in 1 case. There were sagittal sinus thrombosis in 1 case and sagittal and transvers sinus thrombosis in another case with intracranial venous thrombosis. Aneurysms of medial cerebral artery, posterior and anterior communicating artery were detected in cases with subarachnoid hemorrhage. Focal neurologic deficit, and seizure and headache in addition to focal neurologic deficit were common in ischemic and hemorrhagic cerebrovascular accidents respectively. Clinical improvement was partial in 13 cases and complete in 4 cases. There was no clinical improvement in 1 case, and 1 case died. Conclusions: Early detection and treatment of risk factors like cardiovasculardisorders and eclampsia in pregnancy may have favorable influence on maternal mortality and morbidity.