[Clinical and imaging features of hemorrhagic stroke during pregnancy and puerperium].

OBJECTIVE

To investigate the clinical and imaging features of hemorrhagic stroke during pregnancy and puerperium (HSPP).

METHODS

A retrospective analysis was conducted about timing, precipitating factors, clinical manifestations, imaging characteristics, treatment and outcome of 7 HSPP patients.

RESULTS

None of 7 HSPP occurred in the first trimester, 3 in the second trimester, 2 in the third trimester and 2 in the puerperium. Three of 4 patients whose etiology was due to ruptured arteriovenous malformations (AVM) occurred in the second trimester, including one case in the puerperium. Two patients had been diagnosed as cerebral vascular AVM before pregnancy. One patient had eclampsia during pregnancy. The initial symptoms and signs of 7 patients: 4 cases with headache, nausea and vomiting, 4 cases with extremity paralysis, 3 cases with disorders of consciousness, 4 cases with aphasia, 2 cases with central face and tongue paralysis and 1 case with extremity numbness. Cerebral imaging investigations showed 2 cases with basilar ganglia hemorrhage, 4 cases with lobar hemorrhage and 1 case with subarachnoid hemorrhage (SAH). There were 4 cases whose etiology was because of ruptured AVM. Two of 7 patients were treated with operation, 2 with endovascular intervention and 3 with conservative treatment. The prognosis included full recovery (1/7), marked improvement (4/7), slight improvement (1/7) and death (1/7).

CONCLUSION

The onset time of HSPP concentrated in the second, third trimester and the puerperium; Onset time of the patients because of ruptured AVM concentrated in the second trimester. Cerebral imaging examination could elucidate the nature of lesion and the etiology of disease.