Postpartum Cerebral Angiopathy Possibly Due to Bromocriptine Therapy

Abstract

Other adverse effects due to vasoconstriction have been reported during bromocriptine therapy, such as myocardial infarction and arterial hypertension. This case suggests that a similar mechanism may be possible in cerebral arteries, although the cause of vasoconstriction remains uncertain.

Reversible Cerebral Vasoconstriction Syndrome Associated with Subarachnoid Hemorrhage

“…Neurological deficits range from mild to severe but usually improve as the vasculopathy resolves. While some cases are idiopathic [3], there appears to be an association with child birth [4], exertion [5], acute arterial hypertension [4,[6][7][8][9][10][11], and the administration of sympathomimetic [12], serotonergic [13][14][15], and dopaminergic drugs [16].…”

Pregnancy and stroke

“…The differential diagnosis of this presentation is wide [18], but special considerations are pregnancy-associated arterial intimal hyperplasia [16] or arterial spasm due to relative hypertension [17]. Several drugs have been implicated as possible causes, especially ergot derivatives [20,21] due to their sympathomimetic properties. Treatment depends on the underlying cause.…”

Recurrent Intracranial Hemorrhage Due to Postpartum Cerebral Angiopathy

“…10 Because hypertension was not demonstrated in our patient and in other cases of postpartum angiopathy, a direct vasospastic effect secondary to insults other than hypertension must be considered. 15,16 There are now several reports of a benign form of isolated central nervous system angiitis occurring in the absence of pregnancy or the postpartum. 30 -32 Patients are usually healthy young women with relatively benign disease characterized by acute headache, seizures, neurological deficits, and angiographic findings consistent with vasospasm or vasculitis.…”