Delayed angiographic changes in postpartum cerebral angiopathy

Postpartum cerebral angiopathy presenting with non-aneurysmal subarachnoid hemorrhage and interval development of neurological deficits: A case report and review of literature

“…23 reported resolution or significant improvement of headache; four were left with a neurological deficit; [10,20,21,31] five patient died at a median of 12 days after presentation. [7,14,15,22] Reversibility of the segmental vasoconstriction was confirmed by follow-up TCD in 13 patients, [5,6,9,10,13,17,19,[24][25][26]29,32] MRA in 6, [2,10,11,27,31,32] and angiography in 5. [5,12,16,20,28] Overall, PCA patients presenting with SAH does not seem to have a worse outcome than those without.…”

“…[5] Rapid neurological deterioration is a known complication after the initial presentation. [2,[9][10][11][12][13] The clinical course of PCA is typically benign, although neurological impairment (and even death) can result from progressive vasoconstriction, stroke and brain edema. [7,14,15] To the best of our knowledge, only two cases of PCA patients presenting with both SAH and interval development of neurological deficits have been previously reported.…”

“…[5,10,11,15,16,19,[21][22][23][24]26] 15 experienced were generalized tonic-clonic seizures a few days after presentation. [5,6,[9][10][11][12]15,22,[26][27][28][29] Seven were linked to the administration of vasospastic drug. [12,23,[26][27][28][29][30] Eight mentioned a history of migraines.…”

“…[12,23,[26][27][28][29][30] Eight mentioned a history of migraines. [5,7,9,11,20,22,28,29] Segmental vasoconstriction was demonstrated on cerebral angiography in 25 cases, MRA in 8, [6,7,11,15,17,19,31,32] and CTA in 2. [7,15] Fourteen had elevated blood flow velocities on TCD.…”

“…[5,6,9,10,[13][14][15]17,19,22,24,25,29,32] Sixteen suffered deterioration with focal neurological deficits. [2,6,7,[10][11][12][14][15][16][17]20,22,23,25,30] 18 patients were treated with steroids, [6,7,10,[12][13][14][15][16][17][20][21][22][23]25,28,30] sixteen with calcium-channel blockers, [5][6][7]9,[14][15][16]…”