Wang Naiwu, Shen Xudong, Zhang Gang, Gao Bo, Lerner Alexander
Department of Radiology, Jinan City People's Hospital, Laiwu, China.
Department of Radiology, Enshi Center Hospital, Enshi, China.
Quant Imaging Med Surg. 2021 Feb;11(2):838-851. doi: 10.21037/qims-20-830.
Pregnancy-related cerebrovascular disease is a serious complication of pregnancy and puerperium. The etiology and pathological mechanisms of cerebrovascular disease are complex, involving changes in the cardiovascular, endocrine, and immune systems. Vascular risk factors during pregnancy and puerperium may cause vasospasm and endothelial cell damage leading to cerebral ischemia, hemorrhage, posterior reversible encephalopathy syndrome (PRES), and reversible cerebral vasoconstriction syndrome. Arterial or venous obstruction may damage the blood-brain barrier (BBB) and impede venous return, resulting in cerebral edema, hemorrhage, and intracranial hypertension. Pregnancy with hypercoagulability may threaten the lives of both the mother and the developing fetus. With improvements in stroke treatment during pregnancy and puerperium, neuroradiologists have gained new insights into this problem. This article reviews the pathogenesis, imaging findings, and risk factors of stroke during pregnancy and puerperium, focusing on imaging diagnosis and prognostic assessment.
妊娠相关脑血管疾病是妊娠和产褥期的严重并发症。脑血管疾病的病因和病理机制复杂，涉及心血管、内分泌和免疫系统的变化。妊娠和产褥期的血管危险因素可能导致血管痉挛和内皮细胞损伤，进而引起脑缺血、出血、后部可逆性脑病综合征（PRES）和可逆性脑血管收缩综合征。动脉或静脉阻塞可能损害血脑屏障（BBB）并阻碍静脉回流，导致脑水肿、出血和颅内高压。高凝状态的妊娠可能危及母亲和发育中胎儿的生命。随着妊娠和产褥期卒中治疗的改善，神经放射学家对这一问题有了新的认识。本文综述了妊娠和产褥期卒中的发病机制、影像学表现及危险因素，重点关注影像学诊断和预后评估。
