Kittner SJ, Stern BJ, Feeser BR, Hebel R, Nagey DA, et al
Pregnancy and the risk of stroke
N Engl J Med
(Sep) 335:768-774 1996
Kittner et al show that ischemic stroke risk is unchanged during pregnancy,
but rises sharply
during the post-partum period. The risk for hemorrhagic stroke is increased
during pregnancy, and
increased yet again to a much greater extent during the post-partum period.
There was no obvious
explanation for the increased risk of hemorrhagic stroke in the post-partum
or eclampsia were found in only 14% of those women with hemorrhagic stroke.
Changes in blood volume
post-partum or hormonal changes are proposed. There was no obvious way to
patients, even in retrospect. In fact, the stroke patients were younger,
less likely to have
hypertension, and less likely to be current cigarette smokers! The clinical
implications are to have
a high index of suspicion of both ischemic stroke or hemorrhagic stroke in
any post-partum patient
with suggestive symptoms.
(John T. Daugirdas, M.D., University of Illinois at Chicago)
The abstract of this paper is available from the National Library of
Medicine's PubMed site:
click here .