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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 25-year-old woman with a history of chronic severe migraine with aura presented in an apoplectic state 1 week after the delivery of her third child. She developed a severe headache and within hours lapsed into a coma. A CT scan of the brain showed cerebral edema and an occipital hemorrhage. A four-vessel angiogram showed diffuse arterial narrowing of all the intracranial vessels with segmental narrowing of the suprasellar portion of the internal carotid arteries bilaterally. She had no risk factors for stroke or vasculitis. Her pregnancy and delivery were uneventful with no preeclampsia or eclampsia. Apart from ergometrine at the time of the delivery, no vasoconstrictor drugs were used. She recovered spontaneously. Serial CT scans of the brain demonstrated resolution of the edema and hemorrhage with the development of cortical and watershed infarcts. A repeat cerebral angiogram was normal. She was, therefore, diagnosed as having suffered from postpartum cerebral angiopathy, a form of reversible cerebral vasoconstriction, called the Call or Call-Fleming syndrome. The relationship between migraine and postpartum angiopathy in the development of reversible cerebral vasoconstriction is discussed.
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PMID:Case reports: postpartum cerebral angiopathy in a patient with chronic migraine with aura. 1097 65

Stroke from reversible cerebral arterial vasoconstriction has been described in a variety of conditions, including migraine, pregnancy, puerperium (postpartum angiopathy), use of vasoconstrictive drugs, Call-Fleming syndrome, and benign angiopathy of the central nervous system. Although vasoconstriction is an important cause of ischemic and hemorrhagic stroke in young individuals, vasoconstriction syndromes have not been well characterized and remain under-recognized. Misdiagnosis is common because the clinical and radiological features can overlap with conditions such as primary cerebral vasculitis. With the advent of newer, noninvasive angiography techniques and the escalating use of vasoactive drugs, it is likely that clinicians will encounter more patients with vasoconstriction-induced stroke. This article reviews the history, clinical and radiological characteristics, differential diagnosis, and management of cerebral vasoconstriction syndromes.
Top Stroke Rehabil 2004
PMID:Cerebral vasoconstriction syndromes. 1511 61