Kanekar Sangam, Bennett Shante
From the Departments of Radiology (S.K., S.B.) and Neurology (S.K.), Pennsylvania State University and Hershey Medical Center, 500 University Dr, Hershey, PA 17033.
Radiographics. 2016 Nov-Dec;36(7):2102-2122. doi: 10.1148/rg.2016150187.
A number of physiologic, hormonal, immunologic, and hemodynamic changes take place in the maternal body during pregnancy. The majority of these changes are essential for maintaining the normal course of pregnancy. However, these changes may also cause acute or chronic conditions that affect various biologic systems in the mother. In addition, conditions of the central and peripheral nervous systems can cause a variety of neurologic symptoms and complications. Neurologic signs and symptoms in pregnant and postpartum women may be due to the exacerbation of a preexisting medical condition, the initial manifestation of a primary central nervous system-related problem, or a neurologic problem unique to pregnancy and the postpartum period. Because the symptoms of these conditions are either nonspecific or overlapping, it can be challenging to pinpoint the diagnosis clinically. These conditions can be classified into more commonly seen conditions such as headache, venous thrombosis, preeclampsia, subarachnoid hemorrhage, posterior reversible encephalopathy syndrome, and certain pituitary disorders; and less commonly seen entities such as aneurysm, arteriovenous malformation, primary or secondary neoplasm, Sheehan syndrome, and Wernicke encephalopathy. Imaging has an important role in the differentiation and exclusion of various neurologic conditions, and most of the time, imaging findings can point the clinician to a specific diagnosis. The imaging appearances of common and uncommon neurologic conditions that can occur during pregnancy and the early postpartum period are highlighted in this article. RSNA, 2016.
孕期母体体内会发生一系列生理、激素、免疫和血流动力学变化。这些变化大多对维持正常妊娠过程至关重要。然而,这些变化也可能引发影响母亲各种生物系统的急性或慢性疾病。此外,中枢和周围神经系统疾病可导致多种神经症状和并发症。孕妇及产后女性的神经体征和症状可能归因于原有疾病的加重、原发性中枢神经系统相关问题的初始表现,或妊娠及产后特有的神经问题。由于这些疾病的症状要么不具特异性,要么相互重叠,临床上精确诊断具有挑战性。这些疾病可分为较常见的情况,如头痛、静脉血栓形成、先兆子痫、蛛网膜下腔出血、后部可逆性脑病综合征和某些垂体疾病;以及较少见的疾病,如动脉瘤、动静脉畸形、原发性或继发性肿瘤、希恩综合征和韦尼克脑病。影像学在鉴别和排除各种神经疾病方面发挥着重要作用,大多数情况下,影像学检查结果可帮助临床医生做出明确诊断。本文重点介绍了孕期及产后早期可能出现的常见和罕见神经疾病的影像学表现。RSNA,2016年。