Postpartum vasculopathy as a rare cause of stroke – what every neurologist should remember
- Obstetrics & Gynecology International Journal
Stroke in pregnancy and the puerperium is a rare condition. The treatment of ischaemic stroke (IS) in pregnancy and the puerperium is difficult and requires the attending physicians to take quick decisions. Postpartum vasculopathy (PV) may be one of the causes of postpartum stroke. The aetiology of PV is not fully understood. It most often occurs in the first week after delivery. The trigger factors include vasoconstrictive substances that are present in the blood of women in the postpartum period. Most frequently, this condition occurs in a subsequent pregnancy, and the primary symptom is a very severe headache. The characteristic feature of PV is the angiographic image of the cerebral vessels, where segmental vasoconstriction and tortuous course of the vessels are visible, which resembles beads impaled on a string. This disease is a monophasic condition and, once the disease has progressed, there are no contraindications for a subsequent pregnancy. No standard management has been established, but most authors agree that acute phase treatment includes cessation of vasoconstrictors using calcium channel antagonists, magnesium intravenously, corticosteroids, and treatment of associated conditions like headache, high blood pressure, cerebral oedema, seizure. It also applies ASA, heparin when it’s needed, we present a women with an IS in the course of PV treated successfully.
postpartum vasculopathy, puerperium, stroke, headache