Türk Beyin Damar Hast Derg. 2003; 9(2): 63-66

Acute stroke in pregnancy and puerperium

Zekeriya Alioðlu, Vidan Altunayoðlu, Cavit Boz, Mehmet Özmenoðlu
Karadeniz Techical University Faculty Of Medicine, Department Of Neurology, Trabzon

INTRODUCTION: The incidence, causes, and prognosis of the stroke that develops during pregnancy and puerperium are poorly identified. The aim of this study was to determine the types, causes, prognosis, and gestational period of pregnancy related stroke in our clinic.
METHODS: Twenty-two patients with the diagnosis of stroke during pregnancy and puerperium were studied retrospectively among the group of 168 young female acute stroke patients aged 15 to 45 years, from January 1987 to February 2002 in KTU Medical School Department of Neurology.
RESULTS: Nine patients with ischemic stroke, 11 with cerebral hemorrhage, and 2 with cerebral venous thrombosis were identified. Ischemic stroke was appeared in seven patients during 3rd trimester and puerperium. In patients with cerebral hemorrhage, intraparenchymal hemorrhage was observed in 3rd trimester, subarachnoid hemorrhage in 2nd trimester. Eclampsia/preeclampsia was the major cause in ischemic and hemorrhagic stroke. Three patients with intraparanchymal hemorrhage and one patient with dural sinus thrombosis have died during follow up. Mortality was not observed in ischemic patients.
DISCUSSION AND CONCLUSION: Cerebrovascular diseases are the uncommon complications of pregnancy but may cause the maternal and fetal mortality. Strokes in pregnancy usually occur during 3rd trimester and puerperium.

Keywords: Stroke, pregnancy, puerperium.

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Gebelik ve loðusalýkta akut serebrovasküler olaylar

Zekeriya Alioðlu, Vidan Altunayoðlu, Cavit Boz, Mehmet Özmenoðlu
Karadeniz Teknik Üniversitesi Týp Fakültesi, Nöroloji Anabilim Dalý, Trabzon

GÝRÝÞ ve AMAÇ: Gebelik ve loðusalýkta görülen serebrovasküler olaylarýn insidansý, nedenleri ve prognozu net olarak bilinmemektedir. Bu çalýþmada, servisimizde takip edilen gebelikle iliþkili stroklarýn tipini, nedenlerini, prognozunu ve gebelik dönemlerini belirlemek amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Ocak 1987 – Þubat 2002 yýllarý arasýnda KTÜ Nöroloji bölümünde akut serebrovasküler olay tanýsý ile takip edilen 15-45 yaþlarý arasýndaki 168 genç kadýn hasta içinde gebelik ve loðusalýk döneminde olan 22 hasta, retrospektif olarak tarandý.
BULGULAR: Dokuz hastada iskemik strok, 11 hastada serebral kanama, 2 hastada dural sinus trombozu tespit edildi. Ýskemik strok, 7 olguda 3.trimester ve postpartum dönemde geliþti. Serebral hemorajili olgularda intraparankimal kanama 3. trimesterde, subaraknoid kanama ise 2. trimesterde daha fazla gözlendi. Eklampsi/preeklampsi iskemik stroklu ve serebral hemorajili olgularda en sýk nedendi. Ýntraparankimal hematomlu 3 hasta, dural sinus trombozlu bir hasta takip edildikleri dönemde öldüler. Ýskemik stroku olan hastalarda ölüm gözlenmedi.
TARTIÞMA ve SONUÇ: Serebrovasküler olaylar gebeliðin nadir komplikasyonlarýndan olmakla birlikte maternal mortaliteye neden olabilmektedir. Gebelikte serebrovasküler olaylar sýklýkla 3. trimester ve postpartum dönemde geliþmektedir.

Anahtar Kelimeler: Serebrovasküler olay, gebelik, loðusalýk

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