Raroque H G, Tesfa G, Purdy P
Department of Neurology, University of Texas Southwestern Medical Center at Dallas 75235-9115.
Stroke. 1993 Dec;24(12):2108-10. doi: 10.1161/01.str.24.12.2108.
Postpartum cerebral angiopathy is associated with the use of of ergot alkaloids. The exact mechanism is unclear but may be related to their sympathomimetic properties, as evidenced in patients already on other ergot derivatives who deteriorated only after taking additional sympathomimetic drugs. We postulate that sympathomimetic agents, independent of ergot alkaloids, may produce the same complication.
A postpartum patient, initially presenting with headaches, subsequently manifested rapid neurological deterioration after ingesting isometheptene, a sympathomimetic drug. She was not on any ergot derivative but presented similar clinical and radiological manifestations. She experienced increased headache severity, visual disturbance, and seizures associated with multiple segmental cerebral vasoconstriction on angiography and increased T2-weighted signal in the occipital areas on magnetic resonance imaging.
This case is additional evidence that sympathomimetic actions of some drugs, such as ergot derivatives and isometheptene, may lead to postpartum cerebral angiopathy. Documentation of medication used by postpartum women suffering similar complications is needed to verify these findings.
产后脑血管病与麦角生物碱的使用有关。确切机制尚不清楚，但可能与其拟交感神经特性有关，已有服用其他麦角衍生物的患者仅在服用额外的拟交感神经药物后病情恶化可证明这一点。我们推测，独立于麦角生物碱的拟交感神经药物可能会产生相同的并发症。
一名产后患者最初出现头痛，在摄入拟交感神经药物异美汀后随后出现快速神经功能恶化。她未服用任何麦角衍生物，但表现出相似的临床和影像学表现。她头痛加重、出现视觉障碍，并伴有血管造影显示的多节段脑血管收缩以及磁共振成像显示枕叶区域T2加权信号增加。
该病例进一步证明，某些药物如麦角衍生物和异美汀的拟交感神经作用可能导致产后脑血管病。需要记录患有类似并发症的产后妇女所使用的药物，以验证这些发现。
