Postpartum cerebral angiopathy: An important diagnostic consideration in the postpartum period

• Published in: American journal of obstetrics and gynecology Vol. 191; no. 1; pp. 375 - 377
• Main Authors: Konstantinopoulos, Panagiotis A, Mousa, Soha, Khairallah, Ramzi, Mtanos, George
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01.07.2004; Elsevier
• Subjects: Adult; Biological and medical sciences; Central nervous system vasculitis; Cerebral Angiography; Cerebral Hemorrhage - diagnosis; Cerebral Hemorrhage - etiology; Female; Gynecology. Andrology. Obstetrics; Hemorrhagic stroke; Humans; Infarction, Posterior Cerebral Artery - diagnosis; Magnetic Resonance Imaging; Medical sciences; Migraine Disorders - diagnosis; Postpartum cerebral angiopathy; Puerperal Disorders - diagnosis; Vasculitis, Central Nervous System - diagnosis; Central nervous system vasculitis; Postpartum cerebral angiopathy; Hemorrhagic stroke; Postpartum cerebral angiopathy Central nervous system vasculitis Hemorrhagic stroke; Gynecology; Central nervous system; Diagnosis; Puerperium; Obstetrics; Encephalon
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2004.03.028

A 32-year-old woman, gravida 4, para 2, presented with a severe headache 5 days after she had a vaginal delivery with epidural anesthesia. Nine days later she had neurologic symptoms develop. Magnetic resonance imaging and cerebral angiogram were abnormal with evidence of a vasculitis consistent with postpartum cerebral angiopathy. The patient received both methylprednisolone and cyclophosphamide pulses with improvement of her symptoms. This is an important diagnosis for obstetricians to consider because it may result in serious neurologic damage if it is not diagnosed and treated early.