Yadav Jeshika, Bhusal Kiran, Thapaliya Ishwor, Bhandari Khagendra, Jha Swati S, Khadayat Ramesh, Ghimire Asmita
Tribhuvan University, Institute of Medicine, Maharajgunj, Nepal.
Ann Med Surg (Lond). 2024 Aug 7;86(10):6173-6178. doi: 10.1097/MS9.0000000000002455. eCollection 2024 Oct.
Strokes cause 37% of cardiovascular-related deaths in women, with 40% during delivery and 50% postpartum. Pontine hemorrhage, a rare cerebrovascular disease, can occur during pregnancy and postpartum, requiring complex diagnosis and management.
A 33-year-old primipara female presented with headache, vomiting, and altered consciousness at 15 weeks and 5 days gestation. She had no history of head trauma, involuntary urine passage, cough, shortness of breath, palpitation, or per vaginal bleeding. Psychiatric and neurology consultations were conducted to address her symptoms.
Pontine hemorrhage is a rare condition affecting pregnant women, causing mild symptoms like vertigo, ataxia, and dysphagia. Our patient underwent an initial blood investigation with imaging of her brain (CT and MRI) to establish the diagnosis of pontine hemorrhage. It is believed to be caused by hormonal fluctuations, but studies have not proven it. Stroke during pregnancy is rare, with only 10% occurring during the antepartum period. Diagnosis requires a multidisciplinary approach with history, clinical examination, and radiological imaging like CT and MRI. Treatment involved antiplatelet therapy, which ensured favorable maternal and fetal outcomes for our patient.
In summary, this case demonstrates the rare incidence of pontine hemorrhage during pregnancy. It highlights the diagnostic challenges and successful treatment with antiplatelet therapy, emphasizing the necessity for a comprehensive approach to ensure favorable maternal and fetal outcomes.
中风导致37%的女性心血管相关死亡，其中40%发生在分娩期间，50%发生在产后。脑桥出血是一种罕见的脑血管疾病，可发生在孕期和产后，需要复杂的诊断和管理。
一名33岁初产妇在妊娠15周零5天时出现头痛、呕吐和意识改变。她没有头部外伤、尿失禁、咳嗽、气短、心悸或阴道出血史。针对她的症状进行了精神科和神经科会诊。
脑桥出血是一种影响孕妇的罕见病症，会引起眩晕、共济失调和吞咽困难等轻微症状。我们的患者接受了初步血液检查及脑部成像（CT和MRI）以确诊脑桥出血。据信其由激素波动引起，但研究尚未证实这一点。孕期中风很罕见，仅10%发生在产前。诊断需要采用多学科方法，包括病史、临床检查以及CT和MRI等影像学检查。治疗采用了抗血小板治疗，这确保了我们的患者获得良好的母婴结局。
总之，该病例表明孕期脑桥出血的发生率很低。它凸显了诊断挑战以及抗血小板治疗的成功，强调了采取综合方法以确保良好母婴结局的必要性。
