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Review
. 2019 Jul;74(1):5-13.
doi: 10.1161/HYPERTENSIONAHA.118.11513. Epub 2019 May 6.

Preeclampsia and Cerebrovascular Disease

Eliza C Miller  1
Affiliations
Review

Preeclampsia and Cerebrovascular Disease

Eliza C Miller. Hypertension. 2019 Jul.
No abstract available

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Figures

Figure 1.
Figure 1.. Cerebrovascular effects of preeclampsia.
Legend: Preeclampsia (PE) causes both acute and chronic cerebrovascular disease. In the immediate peripartum period, PE is associated with increased blood-brain barrier permeability, impaired cerebral autoregulation, hypercoagulability and inflammation, resulting in complications such as ischemic and hemorrhagic stroke, posterior reversible encephalopathy syndrome, reversible cerebral vasoconstriction syndrome, and cerebral venous sinus thrombosis. Long term, PE is associated with cerebral small vessel disease including stroke and vascular dementia, as well as increased carotid intima-media thickness.
Figure 2.
Figure 2.. Intracerebral hemorrhage in a postpartum woman with preeclampsia.
Legend: A 32-year-old woman presented 4 days postpartum with hypertension and severe headache, found to have severe preeclampsia. Computed tomography of the head without contrast (A) showed left sided intracerebral hemorrhage with cerebral herniation. Cerebral angiogram (B) showed diffuse segmental vasospasm of the proximal and distal large cerebral arteries. Brain biopsy showed no evidence of vasculitis. She was diagnosed with the reversible cerebral vasoconstriction syndrome.
Figure 3.
Figure 3.. Long term cerebral small vessel disease after preeclampsia
Legend: A 47-year-old woman with diabetes, hypertension, active tobacco use and history of preterm preeclampsia presented with left sided weakness and cognitive complaints. Magnetic resonance imaging of the brain with and without contrast showed an acute lacunar infarct in the right internal capsule on diffusion weighted images (A), patchy subcortical white matter hyperintensities on fluid-attenuated inversion recovery sequences (B, C), and no contrast enhancement (D). Additional studies including lumbar puncture showed no evidence of demyelinating disease or other inflammatory etiology. She was diagnosed with ischemic stroke and white matter changes due to cerebral small vessel disease.
See this image and copyright information in PMC

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