Emergent Neuroimaging During Pregnancy and the Postpartum Period

Gao, Guangzu; Zucconi, Rebecca; Zucconi, William

doi:10.1016/j.nic.2018.03.005

Cited by 3 publications

(6 citation statements)

References 63 publications

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“…40 During pregnancy, the adenohypophysis enlarges by 30% as a result of the estrogenic effect on the lactotrophs, and the pituitary reaches about 120% of its usual size about 3 days postpartum. 37,41 Peak growth of an adenoma during pregnancy is between 20 and 24 weeks of gestation. 40 This rapid growth and the high blood flow mimic the conditions of an adenoma.…”

Section: Pituitary Apoplexymentioning

confidence: 99%

“…42 It has a bimodal presentation with incidence in the first trimester (likely a result of concomitant thrombophilia) and the immediate postpartum period. 11,41,42 Typical presentation is a dull headache that slowly worsens over time, although up to 10% may present with a thunderclap headache. 11 Some cases are complicated by seizure, motor weakness, and coma, which can delay the diagnosis in pregnancies complicated by preeclampsia or postdural puncture headache.…”

Section: Central Venous Thrombosismentioning

confidence: 99%

“…11,42 Noncontrast CT imaging may be normal or show hyperattenuation of the thrombosed vein with regional vasogenic edema; therefore, if central venous thrombosis is suspected, the imaging modality of choice is noncontrast magnetic resonance venography. 11,41 Treatment should be initiated with unfractionated or low-molecular-weight heparin (during pregnancy), and evaluation for thrombophilia should be considered.…”

Section: Central Venous Thrombosismentioning

confidence: 99%

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Neurologic Emergencies in Pregnancy

Wesley,

Vates,

Thornburg

2024

Obstetrics &Amp; Gynecology

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Neurologic emergencies in pregnancy require prompt evaluation and early, focused intervention to improve neurologic outcomes for the affected person and to avoid further injury. Neurologic events in pregnancy, although rare, present a time of extreme risk of permanent injury for the person who is pregnant. Therefore, obstetric clinicians should be well versed in the risk factors for potential neurologic events and understand the symptoms and events that should prompt evaluation for a neurologic event. In addition, they should support other specialties in aggressive and early neurologic care for the patient to improve outcomes while assessing fetal well-being and care optimization for the dyad. Obstetric clinicians can uniquely provide knowledge of changes in pregnancy physiology that can increase the risk of neurologic events, as well as change the treatment of these events. For all patients with neurologic events, “time is brain.” Therefore, it is important to be aware of changes in common presenting pregnancy concerns that should prompt evaluation for other pathogeneses. Finally, pregnancy care teams should be prepared to begin the initial stabilization and management of acute neurologic emergencies, including seizure, stroke, and meningitis, while seeking aid from other medical and neurologic specialists who can support their care and interventions. Early and aggressive interventions for individuals with neurologic events during pregnancy and postpartum are critical to the overall well-being of the dyad.

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Section: Pituitary Apoplexymentioning

confidence: 99%

Section: Central Venous Thrombosismentioning

confidence: 99%

Section: Central Venous Thrombosismentioning

confidence: 99%

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Neurologic Emergencies in Pregnancy

Wesley,

Vates,

Thornburg

2024

Obstetrics &Amp; Gynecology

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“…Another possible mechanism revolved around the normal physiological changes in pregnancy where Gao and colleagues [12] noted that the increase in several clotting factors, decreased inhibition of clotting mechanisms, and inhibition of fibrinolysis in the pregnant population, there is an increased risk of thromboembolism, which persists six weeks into the postpartum period. They further elaborated that the total blood volume increases by 40% at term, leading to an increased risk of hypertension, and rising progesterone levels in the third trimester contribute to increased venous compliance, capillary leakage, and vasogenic edema.…”

Section: Pathophysiologymentioning

confidence: 99%

“…A diagnostic challenge inherent to acute neurologic conditions during pregnancy and the postpartum period is that the presenting symptoms of several distinct pathologic conditions often overlap, and the conditions themselves are not mutually exclusive [12].…”

Section: Pathophysiologymentioning

confidence: 99%

Bilateral chronic subdural hematoma in postpartum period: Case report and review of literature

Mujuni

Njau

Kenemo

et al. 2022

J Case Rep Images Obstet Gynecol

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Introduction: Postpartum chronic subdural hematoma (PCSDH) of non-traumatic origin is a rare but potentially life-threatening complication in the obstetric population which usually presents with severe headache. Case Report: We describe timely diagnosis and surgical management of a 27-year-old female patient with bilateral chronic subdural hematoma of non-traumatic origin in the post-postpartum period for which surgical management was employed following irresponsive conservative management. Conclusion: The suspicion of chronic subdural hematoma should be considered in any patient complaining of severe persistent headache following spinal anesthesia in the postpartum period and requires prompt neuroimaging for timely identification. Surgical management following irresponsive conservative management in selected patients can be achieved with satisfactory outcomes.

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Diagnostic Testing for Migraine and Other Primary Headaches

Evans

2019

Neurologic Clinics

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Emergent Neuroimaging During Pregnancy and the Postpartum Period

Cited by 3 publications

References 63 publications

Neurologic Emergencies in Pregnancy

Neurologic Emergencies in Pregnancy

Bilateral chronic subdural hematoma in postpartum period: Case report and review of literature

Diagnostic Testing for Migraine and Other Primary Headaches

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