Acute Neurological Disorders in Women during Pregnancy and Peurperium- A Cross Sectional Study

Abstract

Objective: To describe various imaging feature of acute neurological complications during pregnancy and puerperium, thereby sensitising the treating physician to necessitate appropriate treatment.
Method: A cross sectional prospective study (MRI Brain) was done on 105 women suspected of acute neurological disorders during pregnancy and puerperium during the period January 2017- January 2018 in the department of Radiodiagnosis, in SSIMS & RC, Davangere and the results were analyzed.
Results: Posterior Reversible Encephalopathy Syndrome was the most common neurological disorders in our study, accounting for 36% of acute neurological disorder followed by cerebrovascular thrombosis (CVT) (accounting for 22.8%), cerebrovascular accident (CVA) (8.2%), SAH (6.6%), meningitis (4.7%), Wernicke’s encephalopathy (1.9%) and pituitary disorders (1.9%). 19 patients (17.7%) of the total had normal features on imaging.
We also characterised 3 imaging patterns of posterior reversible encephalopathy syndrome, which was the most common neurological disorder.
Typical feature consisting of bilateral symmetrical T2 and FLAIR hyperintensities with no diffusion restriction on MRI.
Bilateral symmetrical T2 and FLAIR hyperintensity with subtle diffusion restriction on MRI.
Bilateral symmetrical T2 and FLAIR hyperintensity with foci of hemorrhage.
Conclusion: The incidence of acute neurological complication in pregnancy and puerperium is fairly high. PRES (36.1%) and CVT (22.8%) were the most common entities noticed. The most common presenting symptom is headache followed by seizures. Women in their puerperal period (from day 5-day 10) were more vulnerable for acute neurological complications according to our study. Hence timely imaging and familiarising spectrum of radiological features in women during pregnancy and puerperium is needed for initiating early therapy and preventing complications for both the mother and the fetus.