POSTPARTUM CEREBRAL ANGIOPATHY - A RARE CEREBROVASCULAR COMPLICATION

We describe two patients with post-partum cerebral angiopathy. (Case 1 ) A 24-year-old patient developed vaginal bleeding 1 day post-partum S he received blood transfusion and ergometrine. Four days later she exp erienced severe occipital headache, loss of vision and generalized sei zures. An MRI showed right occipital lesion. She was treated with phen ytoin and prednisone. Her vision returned to normal within 2 days. Cer ebral angiography showed multiple segmental narrowing; 6h later severe occipital headache and cortical blindness recurred. She was treated w ith nimodipine and prednisone with complete recovery in 10 days. (Case 2) On the 7th post-partum day a 24-year-old patient was given ergomet rine. One day later she developed severe headache and hypertension, fo llowed by drowsiness, right hemiplegia and aphasia. A left frontal hem atoma was seen on the CT scan. Cerebral angiography showed multiple se gmental narrowing. Resolution of this angiography was confirmed on fol low-up angiography. Post-partum cerebral angiopathy is a rare complica tion of a normal pregnancy. It may present as an ischemic or hemorrhag ic stroke. The transience of this severe complication and its associat ion with the administration of drugs,vith strong vasoconstrictive prop erties suggest an etiological relationship. Other factors and the exac t mechanism are unclear. Eur J Neurol 5:411-416 (C) 1998 Lippincott-Ra ven Publishers.