Wiebers D O
Arch Neurol. 1985 Nov;42(11):1106-13. doi: 10.1001/archneur.1985.04060100092030.
Pregnancy increases the risk of focal ischemic cerebrovascular events, apparently to about 13 times the expected rate outside of pregnancy in the case of cerebral infarction. The distribution of the underlying pathophysiologic mechanisms causing the cerebrovascular symptoms in pregnant patients differs considerably from the distribution in the general population. Although most focal ischemic lesions that occur during pregnancy seem to be the result of arterial occlusion, cerebral venous thrombosis is still a prominent factor in causing such lesions. Arterial occlusions tend to occur during the second and third trimesters of pregnancy and during the first week after delivery, whereas the venous occlusions tend to occur one to four weeks after childbirth. When possible, treatment of patients with focal ischemic neurologic symptoms is based on a precise definition of the underlying pathophysiologic mechanism and its appropriate treatment. When this is not possible, patients are treated according to categorization based on the temporal profile of the focal deficit.
怀孕会增加局灶性缺血性脑血管事件的风险，就脑梗死而言，这一风险显然约为非孕期预期发生率的13倍。导致孕妇出现脑血管症状的潜在病理生理机制分布与普通人群有很大差异。虽然孕期发生的大多数局灶性缺血性病变似乎是动脉闭塞的结果，但脑静脉血栓形成仍是导致此类病变的一个重要因素。动脉闭塞往往发生在妊娠中期和晚期以及分娩后的第一周，而静脉闭塞则往往发生在产后一至四周。在可能的情况下，对局灶性缺血性神经症状患者的治疗基于对潜在病理生理机制的精确定义及其适当治疗。当无法做到这一点时，则根据局灶性缺损的时间特征进行分类治疗。
