Pathophysiology of Cerebral Vascular Dysfunction in Pregnancy-Induced Hypertension

Abstract

Purpose of Review To review and summarize what is known about cerebrovascular derangements during preeclampsia. Recent Findings Preeclampsia is a devastating disorder of pregnancy with no known cure. Little is known about the pathophysiological mechanisms which lead to the symptoms of the disorder, particularly with regard to individual vascular beds such as the cerebral circulation. Studies suggest that the cerebrovascular dysfunction characteristic of the preeclampsia syndrome is characterized by alterations in cerebral blood flow autoregulation and opening of the blood–brain barrier. Mechanistic studies demonstrate that the same circulating factors implicated in the pathophysiology of other vascular beds may be operative in the cerebral circulation as well. However, significant knowledge gaps still exist, highlighting the need for more intense research in this field. Summary Little is known about cerebrovascular dysfunction during preeclampsia, and detailed mechanistic studies are needed to identify the molecular pathways involved, the interactions thereof, and how those pathways lead to clinical disease.

Prenatal intake of omega‐3 promotes Wnt/β‐catenin signaling pathway, and preserves integrity of the blood–brain barrier in preeclamptic rats

“…VEGF is a central requirement for stabilization of endothelial cells in mature blood vessels and it is particularly important in the health of the fenestrated and sinusoidal endothelium found in the renal glomerulus, brain, and liver organs (Maynard & Karumanchi, 2011). VEGF blockade represents a crucial factor in the pathophysiology of preeclampsia (Younes & Ryan, 2019). Current data showed significant decrease in area % of VEGF immune-staining in PE group compared to both control normal and normal pregnant rats supplemented with omega-3.…”

Clinical and Imaging Data-Based Model for Predicting Reversible Posterior Leukoencephalopathy Syndrome (RPLS) in Pregnant Women With Severe Preeclampsia or Eclampsia and Analysis of Perinatal Outcomes

“…Brain hyperperfusion and vasospasm are the most crucial research mechanisms. The common imaging manifestations of nervous system injury related to preeclampsia are stroke and RPLS [ 12 , 13 ].…”

Efficacy of normodyne-magnesium sulfate combination treatment on pregnancy-induced hypertension, and its effect on VEGF and Flt-1 levels

“…The clinical symptoms of PIH are rather hidden before 20 weeks of pregnancy. This frequently results in varying degrees of damage to the mother and the fetus at the time of diagnosis [12]. Therefore, for patients with PIH, timely diagnosis and treatment are of great clinical significance.…”