Intracerebral hemorrhage and postpartum cerebral vasculopathy

Romergryko G. Geocadin, Alexander Y. Razumovsky, Robert J. Wityk, Anish Bhardwaj, John A. Ulatowski

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Introduction: Intracerebral hemorrhage (ICH) associated with pregnancy commonly occurs in the postpartum period in the setting of preeclampsia/eclampsia. We describe the clinical course of two patients with ICH due to postpartum cerebral vasculopathy in the absence of toxemia. Methods: We reviewed two cases with ICH and postpartum vasculopathy in our hospital (1996-2001) and compared them with seven similar case reports from the literature. Results: Mean age of all patients is 28.7±5.6 years (mean±S.D.). Toxemia of pregnancy was absent in all cases. ICHs were cortical in eight and putaminal in one patient. Erythrocyte sedimentation rate was elevated in two. Two cases rehemorrhaged during the same admission. No cerebral infarctions were reported. All patients had diffuse vasculopathy on conventional catheter angiography, with no clinical manifestations or laboratory data supportive of extracerebral or systemic vasculitis. Eight patients were treated with corticosteroids, two with additional cytotoxic agents and one with nimodipine alone. Improvement on follow-up cerebral angiography (catheter or MRA) and transcranial Doppler ultrasonography (TCD) was noted in eight cases. One did not have follow-up cerebral imaging but had an excellent clinical outcome. All cases had good to excellent functional recovery. Conclusions: Postpartum ICH in the absence of toxemia may be associated with isolated cerebral vasculopathy. The clinical course and functional outcome is good to excellent. This entity appears to be distinct from cerebral vasculitis, which is usually associated with poor outcome.

Original languageEnglish (US)
Pages (from-to)29-34
Number of pages6
JournalJournal of the Neurological Sciences
Volume205
Issue number1
DOIs
StatePublished - Dec 15 2002
Externally publishedYes

Fingerprint

Cerebral Hemorrhage
Postpartum Period
Toxemia
Pre-Eclampsia
Catheters
Central Nervous System Vasculitis
Doppler Transcranial Ultrasonography
Postpartum Hemorrhage
Systemic Vasculitis
Nimodipine
Eclampsia
Cerebral Angiography
Blood Sedimentation
Cerebral Infarction
Cytotoxins
Angiography
Adrenal Cortex Hormones
Pregnancy

Keywords

  • Intracerebral hemorrhage
  • Postpartum
  • Transcranial Doppler ultrasound
  • Vasculitis

ASJC Scopus subject areas

  • Aging
  • Clinical Neurology
  • Surgery
  • Developmental Neuroscience
  • Neurology
  • Neuroscience(all)

Cite this

Intracerebral hemorrhage and postpartum cerebral vasculopathy. / Geocadin, Romergryko G.; Razumovsky, Alexander Y.; Wityk, Robert J.; Bhardwaj, Anish; Ulatowski, John A.

In: Journal of the Neurological Sciences, Vol. 205, No. 1, 15.12.2002, p. 29-34.

Research output: Contribution to journalArticle

Geocadin, Romergryko G. ; Razumovsky, Alexander Y. ; Wityk, Robert J. ; Bhardwaj, Anish ; Ulatowski, John A. / Intracerebral hemorrhage and postpartum cerebral vasculopathy. In: Journal of the Neurological Sciences. 2002 ; Vol. 205, No. 1. pp. 29-34.
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