Wildman Jenna Kaye, Rimawi Bassam H
University of South Alabama, Children's and Women's Hospital, Department of Obstetrics and Gynecology, 251 Cox Street, Mobile, AL 36604, United States.
Division of Maternal Fetal Medicine, United States.
Case Rep Womens Health. 2019 Jan 23;21:e00097. doi: 10.1016/j.crwh.2019.e00097. eCollection 2019 Jan.
Cerebrovascular disease is not uncommon during pregnancy as a result of either venous or arterial occlusion, or a hemorrhagic event, resulting in ischemia. Pregnancy may alter the prognosis of these neurologic disorders, with increased risks of morbidity and mortality for the mother and the developing fetus. Etiologies of stroke during pregnancy and the postpartum period include preeclampsia, eclampsia, HELLP syndrome, posterior reversible encephalopathy syndrome (PRES), amniotic fluid embolism, postpartum angiopathy, postpartum cardiomyopathy, thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), cerebral venous thrombosis, CNS infections, and maternal thrombophilia. Essentially any of the vessels in the brain can be involved in cerebral infarction; however, pontine infarctions are rare and are generally secondary to occlusive insults or after dissection of an aneurysm. Though not common, these conditions can result in devastating sequelae and significant disability. Scant literature is available regarding pontine infarctions during pregnancy. Here we present a rare case of a pregnant patient who presented with new-onset seizures and was found to have a cerebral pontine infarction on imaging. The purpose of this article is to summarize existing data regarding the incidence, risk factors, and potential etiologies, as well as treatment strategies for pontine infarctions during pregnancy.
由于静脉或动脉阻塞或出血事件导致缺血，脑血管疾病在孕期并不罕见。怀孕可能会改变这些神经系统疾病的预后，增加母亲和发育中胎儿发病和死亡的风险。孕期和产后中风的病因包括先兆子痫、子痫、HELLP综合征、后部可逆性脑病综合征（PRES）、羊水栓塞、产后血管病、产后心肌病、血栓性血小板减少性紫癜（TTP）、溶血尿毒症综合征（HUS）、脑静脉血栓形成、中枢神经系统感染和母体血栓形成倾向。本质上，大脑中的任何血管都可能参与脑梗死；然而，脑桥梗死很少见，通常继发于闭塞性损伤或动脉瘤夹层之后。尽管并不常见，但这些情况可导致严重后果和显著残疾。关于孕期脑桥梗死的文献很少。在此，我们报告一例罕见的孕妇病例，该孕妇出现新发癫痫，影像学检查发现脑桥梗死。本文的目的是总结关于孕期脑桥梗死的发病率、危险因素、潜在病因以及治疗策略的现有数据。
