A case of postpartum cerebral angiitis and review of the literature

Arch Gynecol Obstet. 2011 Mar;283(3):663-8. doi: 10.1007/s00404-010-1471-8. Epub 2010 Apr 24.

Abstract

Purpose: To better characterize postpartum cerebral angiitis (PPCA).

Methods: We present a case of PPCA in which a 34-year-old G6P5104 underwent a normal vaginal delivery and developed PPCA. She had no signs or symptoms of gestational hypertension or preeclampsia. She had a history of migraines and received methylergonovine at delivery. She represented postpartum with headache and hypertension. The patient had characteristic findings of cerebral angiitis on imaging, and was diagnosed with PPCA. She was treated with nimodipine and steroids. She was monitored with transcranial Dopplers.

Results: In reviewing the literature, we found 23 cases of PPCA. We found that none had proteinuria, most were hypertensive, and all presented with headache.

Conclusions: Use of sympathomimetic agents, particularly among those with migraines, may increase risk of PPCA.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antihypertensive Agents / therapeutic use
  • Cerebral Angiography
  • Female
  • Humans
  • Hypertension / drug therapy
  • Migraine Disorders / drug therapy
  • Nimodipine / therapeutic use
  • Postpartum Period / drug effects
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / drug therapy
  • Steroids / therapeutic use
  • Treatment Outcome
  • Vasculitis, Central Nervous System / diagnosis*
  • Vasculitis, Central Nervous System / drug therapy

Substances

  • Antihypertensive Agents
  • Steroids
  • Nimodipine