Pre-eclampsia Associated with Carotid Dissection and Stroke in a Young Woman

Dasgupta, Noel R.; Guzmán, Luis A.; Chapman, Doug B.

doi:10.1016/j.jstrokecerebrovasdis.2009.03.020

Cited by 7 publications

(4 citation statements)

References 8 publications

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“…The literature search in PubMed and in Chinese medical network databases yielded 30 articles including 44 patients with postpartum cerebral arterial dissections [6,16–43] (Table 1). Including the case from our hospital, there were a total of 45 patients, with an age range of 24 to 44 years (mean 34).…”

Section: Resultsmentioning

confidence: 99%

Postpartum cerebral arterial dissections

et al. 2021

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Postpartum cerebral arterial dissections are rare, and the clinical features, diagnosis, and treatment approaches are not clear to many physicians. This study was to investigate the clinical features, diagnosis, and treatment of postpartum cerebral arterial dissections.One patient with postpartum cerebral arterial dissections enrolled in our hospital was analyzed. All patients with postpartum cerebral arterial dissections retrieved from the PubMed were also included in this study and analyzed.A total of 45 patients with postpartum cerebral arterial dissections were retrieved including our case, with an age range of 24 to 44 years (mean 34). Thirty-six (80%) patients were older than 30 years of age (mean 35). There were 17 cases of cesarean section, 14 cases of natural labor, and 14 cases whose delivery modes were not reported. The clinical symptoms included headache in 35 cases (78%) and neck pain in 14 (31%). The symptoms occurred at a mean time of 11 days (range 0-53 days) following delivery. Among 45 patients, arterial dissections involved unilateral carotid or vertebral artery in 29 cases (64%), bilateral carotid or vertebral arteries in 8 (18%), 3 arteries in 3 (7%), and all bilateral carotid and vertebral arteries in 5 (11%). Fourteen (31%) patients were treated with antiplatelet agents, 27 (60%) with anticoagulation, 7 (16%) with both antiplatelet and anticoagulation medications, and only 2 (4%) with stent angioplasty. The prognosis was complete recovery in 30 (86%) patients and mild focal neurological symptoms in 5 (14%).Postpartum cerebral arterial dissections are rare, and correct diagnosis relies on imaging examination. Prognosis is usually favorable in patients with early diagnosis and prompt treatment.

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Section: Resultsmentioning

confidence: 99%

Postpartum cerebral arterial dissections

et al. 2021

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“…Vascular wall remodeling that results in increased vascular volume and compliance may make vessels more susceptible to dissection, while increased cardiac output and blood flow through the carotid arteries may lead to changes in shearing forces across the endothelial surface, resulting in greater risk for an intimal tear [ 11 , 17 , 18 ]. The hypercoagulable state of pregnancy contributes to development of thrombosis at the area of dissection, with subsequent development of embolism [ 11 , 17 ]. In addition, expulsive efforts in the second stage of labor may theoretically precipitate dissection [ 11 , 15 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Resolution of Internal Carotid Dissection with Middle Cerebral Artery Occlusion in Pregnancy

Ulrich

Johnson

Jodry

et al. 2015

Case Reports in Neurological Medicine

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Introduction. Cervical artery dissection (CAD) is a common cause of stroke in younger patients. While the incidence of stroke in pregnancy is increasing, CAD remains a rare cause of ischemic stroke in the pregnant population, with only 30 cases described in the literature, most in the postpartum period. Methods. The case of a pregnant patient at 18 weeks of gestation presenting with CAD and ischemic stroke following intercourse is discussed. Discussion. CAD results from an intimal tear in the carotid artery, allowing accumulation of blood in the vessel wall. Stroke results from embolization of thrombogenic material in the wall. Etiology includes minor trauma, connective tissue disorders, or anatomic variations of the carotid artery. Most patients present with headache and/or neck pain, while ischemic symptoms are seen in at least 50% of patients. In the pregnant population, imaging with MRI or MRA of the head and neck aids in diagnosis. Once the diagnosis is made, patients are treated with either anticoagulation or antiplatelet medications. The optimal treatment in both pregnant and nonpregnant patients has not been well-studied. Conclusion. CAD is an important diagnosis to consider in a pregnant patient with persistent headache, especially if neurological symptoms are present. Imaging should be quickly obtained so treatment can be initiated.

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“…Cerebral angiographic studies should be carried out to exclude vascular malformations, including cerebral aneurysms, arterial thrombosis or CVST, among other cerebrovascular abnormalities. Evaluation of the extracranial cerebrovasculature should be considered since cervical arterial dissections have been reported in preeclampsia presenting with acute n eurological deficits [40].…”

Section: Neuroimaging Studies In Preeclampsia and Eclampsiamentioning

confidence: 99%

Stroke- and Pregnancy-Induced Hypertensive Syndromes

Morales-Vidal

Schneck

Flaster

et al. 2011

Womens Health (Lond Engl)

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Pregnancy-induced hypertensive syndromes are an important cause of cerebrovascular diseases during pregnancy. Women with pregnancy-induced hypertensive syndromes are at an increased risk of ischemic and hemorrhagic strokes. Posterior reversible encephalopathy and reversible vasoconstriction syndromes are common. Cerebral venous sinus thrombosis may also occur. Preeclampsia and eclampsia reflect generalized endothelial dysfunction. Prompt diagnosis and identification of patients at risk allows for early therapeutic interventions and improved clinical outcomes.

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Pre-eclampsia Associated with Carotid Dissection and Stroke in a Young Woman

Cited by 7 publications

References 8 publications

Postpartum cerebral arterial dissections

Postpartum cerebral arterial dissections

Resolution of Internal Carotid Dissection with Middle Cerebral Artery Occlusion in Pregnancy

Stroke- and Pregnancy-Induced Hypertensive Syndromes

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