Dissections after childbirth

Abstract

The occurrence of spontaneous internal carotid or vertebral artery dissection after childbirth remains rare. To our knowledge, seven cases of arterial dissection in the postpartum period have been described in the literature as single case reports. We report four additional cases of internal carotid and vertebral artery dissection in the puerperal period, documented by angiography. Physicians should consider the possibility of arterial dissection in any young patient presenting with acute ischemic stroke, including women in the postpartum period. The availability of modern noninvasive ultrasound and imaging techniques may result in earlier diagnosis and facilitate identification of this condition.

Postpartum Cervicocephalic Artery Dissection

“…1,[3][4][5][6][7] In addition, 2 patients with basilar artery dissection have been described. 8 We report 6 women with 8 ppCAD (6 VAD and 2 ICAD).…”

Internal carotid artery dissection: an unusual cause of postpartum headache

“…Approximately 80% of cases are complicated by embolic stroke, 15 so rapid diagnosis and anticoagulation are essential to minimize further morbidity and mortality. 16,17 Seven post-partum cases of ICAD have been described in the literature, [18][19][20][21][22] and are summarized in Table 1. Parturition may precipitate or exacerbate ICAD for several reasons.…”

“…In addition, expulsive efforts have been proposed as a precipitating factor for those patients who reached the second stage of labor. [18][19][20]22 Finally, the hypercoagulable state of pregnancy contributes to the development thrombosis at the dissection site and subsequent distal embolism.…”

Vier-Gefäß-Dissektion nach protrahierter Geburt

“…Unseres Wissens wurden bisher 11 Fälle postpartaler Dissektionen veröf-fentlicht, bei denen jedoch jeweils nur ein extrakranielles Gefäß betroffen war [6]. Inwieweit der Zusammenhang zwischen Geburt und Gefäßdissektion kausal oder koinzident war, blieb stets unklar.…”