Miyakoshi Kei, Matsuoka Misugi, Yasutomi Daisuke, Tanaka Mamoru, Yakubo Kazumi, Fukuiya Tatsuro, Yoshimura Yasunori
Department of Obstetrics and Gynecology, Saitama City Hospital, Midori-ku, Saitama City, Saitama, Japan.
J Obstet Gynaecol Res. 2009 Oct;35(5):974-7. doi: 10.1111/j.1447-0756.2009.01031.x.
Stroke during pregnancy or the puerperium is an extremely rare yet serious cause of perinatal morbidity and mortality. Moyamoya disease, a cerebrovascular occlusive pathology with a female predominance, may become symptomatic for the first time in association with pregnancy. A 36-year-old woman with postpartum pre-eclampsia suddenly developed hemiparesis in the left arm with dysarthria after the initiation of antihypertensive measures. Cranial magnetic resonance imaging and angiography revealed acute ischemic lesions in the right hemisphere along with the steno-occlusive lesions of bilateral terminal portions of the internal carotid artery, indicating Moyamoya disease. With anti-platelet medication, the patient recovered gradually and was diagnosed as having Moyamoya disease using conventional angiography 3 months postpartum. In this case, the fluctuations in blood pressure in association with pre-eclampsia appear to have exacerbated the clinical symptoms of Moyamoya disease. As such, Moyamoya disease should be considered as an underlying disease of ischemic stroke associated with pregnancy.
妊娠或产褥期发生的中风是围产期发病和死亡的一种极其罕见但严重的原因。烟雾病是一种女性占优势的脑血管闭塞性病变，可能首次在妊娠期间出现症状。一名36岁患有产后先兆子痫的妇女在采取降压措施后突然出现左臂偏瘫和构音障碍。头颅磁共振成像和血管造影显示右半球急性缺血性病变以及双侧颈内动脉终末段的狭窄闭塞性病变，提示烟雾病。通过抗血小板药物治疗，患者逐渐康复，并在产后3个月使用传统血管造影被诊断为烟雾病。在这种情况下，与先兆子痫相关的血压波动似乎加剧了烟雾病的临床症状。因此，烟雾病应被视为与妊娠相关的缺血性中风的潜在病因。
