妊娠相关脑卒中合并脑疝的临床分析

Clinical analysis of stroke and cerebral hernia related to pregnancy

目的总结妊娠相关脑卒中合并脑疝的临床特点,以提高对本病的认识。方法回顾性分析2004年1月至2007年11月收治的妊娠及产后6个月内妊娠相关脑卒中合并脑疝5例患者的临床资料。结果5例妊娠相关脑卒中合并脑疝者,确诊脑出血1例,脑动静脉畸形伴脑出血1例,颅内静脉窦血栓形成1例,颅内静脉窦血栓形成或侧裂静脉及Labbe静脉血栓形成伴脑出血2例。3例围生儿或胎儿存活,2例死亡。结论当孕产妇出现神经症状及体征时,临床医师应考虑脑卒中的可能,急行CT、MRI、血管造影检查确诊,及时手术以挽救母婴生命。

Objective To analyze the clinical manifestations of stroke and cerebral hernia related to pregnancy with emphasis on the relationship between the timing, etiology, risk factors and the maternal and fetal outcomes. Methods From January 2004 to November 2007 patients with stroke during pregnancy or within 6 weeks of postpartum were admitted to our hospital. Stroke was classified as cerebral hemorrhage （CH）, subarachnoid hemorrhage （SAH）, thrombosis of intracranial venous sinus and cerebral infarction （CI）. All patients were investigated with at least one examination of CT, MRI or DSA. Results Five patients were identified including one with ICH, one with ICH caused by arteriovenous malformation （AVM）, one with thrombosis of intracranial venous sinus, two with thrombosis of intracranial venous sinus or Sylvian and Labbe veins accompanied by ICH. There were three babies survived, two died or aborted. Conclusions Whenever the neurological symptoms and signs appeared the clinicians should think of stroke and make definite diagnosis by CT,MRI or angiography. Proper management in time will achieve the best outcome for the mother and fetus.