University of Florida at Jacksonville, Department of Neurology, United States of America.
Wake Forest School of Medicine, Department of Neurology, United States of America.
Neurobiol Dis. 2022 Jul;169:105735. doi: 10.1016/j.nbd.2022.105735. Epub 2022 Apr 25.
Stroke associated with pregnancy and post-partum occurs in about 30 per 100,000 deliveries, and includes subtypes of ischemic and hemorrhagic stroke as well as cerebral venous sinus thrombosis (CVST). There are a wide variety of underlying causes and risk factors, some that are common to both pregnant and non-pregnant women, and others that are unique to pregnancy. Although some of the strokes that occur may be a direct result of the pregnancy itself, such as hypertensive disorders of pregnancy, others could be anticipated or prevented by understanding the risk factors. These may include the presence of pre-pregnancy clotting disorders, aneurysms or arteriovenous malformations, hypertension, diabetes, or advanced maternal age. Treatment of stroke during pregnancy is based on the current recommendations for non-pregnant stroke patients, assuming the benefit of these treatments is likely higher than the risks. These decisions must be made with the appropriate specialists in stroke and endovascular treatment, as well as high-risk obstetrician/gynecologists, and most importantly, patient and family preferences.
妊娠和产后相关的脑卒中发病率约为每 10 万分娩 30 例，包括缺血性卒中和出血性卒中等亚型，以及脑静脉窦血栓形成（CVST）。其病因和危险因素多种多样，有些在孕妇和非孕妇中都很常见，有些则是妊娠所特有的。虽然有些发生的脑卒中可能是妊娠本身的直接结果，如妊娠高血压疾病，但通过了解危险因素，可以预料或预防其他脑卒中。这些危险因素可能包括孕前存在凝血障碍、动脉瘤或动静脉畸形、高血压、糖尿病或高龄产妇。妊娠期间的脑卒中治疗基于目前针对非妊娠脑卒中患者的推荐，因为这些治疗的获益可能高于风险。这些决策必须与卒中和血管内治疗的专家以及高危产科/妇科医生一起做出，最重要的是，还要考虑患者和家属的意愿。
