Vascular cerebral thrombosis during pregnancy and post-partum

Pregnancy and puerperium are associated with a number of cerebrovascular conditions that may result in stroke. Those include cerebral venous thrombosis and cerebral arteries occlusions. Comparing stroke rates during pregnancy with those of non-pregnant women showed only a marginal excess risk during pregnancy and puerperium. Strokes due to cerebral venous thrombosis represent 10-20 per 100 000 deliveries in western countries. The cause of intracranial venous thrombosis is usually unknown. However, better understanding of abnormalities in coagulation leading to intravascular clotting in the early puerperium is resulting in better understanding of this disease. Nevertheless, an etiological work up should be performed, particularly when the thrombosis occurs during pregnancy. Its clinical manifestations often include focal neurological signs, seizures and headache. Alterations in consciousness occur as intracranial pressure increases. Arterial occlusions account for about 60% to 80% of cerebral ischemic lesions. A probable cause of ischemic stroke is diagnosed on the basis of clinical, biological and radiological data. Eclampsia is the main cause of nonhemorrhagic stroke. A search for rare causes of stroke linked to pregnancy such as post-partum cardiomyopathy, paradoxical embolism, choriocarcinoma, cardiac and hematological disorders may be appropriate.