Stroke in pregnancy, causes, diagnosis, risk factors

 Stroke in pregnancy, causes, diagnosis, risk factors

When the blood supply to a part of brain is hampered for any reason, the clinical condition that it causes is known as stroke.

If we compare similar age groups, women who are pregnant or have just had a delivery are more prone for stroke then their non pregnant counterpart.

Patients with stroke may present with sudden onset severe headache, one side paralysis, fits, first episode migraine and other neurological deficits.

Many a times decreased blood supply is transient and reversible and symptoms recover within 24 hours. This clinical entity is known as transient ischemic attack. Ischemia means less blood supply.

If a pregnant woman presents with stroke, then MRI and angiography of brain and 2D ECHO are done to arrive at diagnosis and to know the probable cause.

In blood, Anti-Phospholipid antibody, lupus anticoagulant are checked and tests are carried out for Sickle Cell syndrome.

Some probable causes and high risk factors are

-Vasculitis

-Vasculopathy

-Pre eclampsia syndrome, that means BP increases during pregnancy

- Chronic hypertension that means the woman was already having high BP when she became pregnant

-She may already be having arterio-venous malformation, meaning there is structural defect in the lining of blood vessels in brain which may lead to spontaneous rupture of some blood vessels known as arterial dissection.

-Some clots may form in the brain. If it is in the artery it is known as arterial thrombosis, if it is in the veins it is known as venous thromboses.

-In Sickle Cell disease faulty haemoglobin structure causes change in the shape of red blood cells. With altered shape these RBC get stuck in micro vasculature. Coupled with the hypercoagulable state of pregnancy, clotting in brain can occur and give rise to stroke.

-Cocaine and methamphetamines drug abuse also put pregnant women at more risk