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Postpartum Cerebral Angiopathy

Tillman BGT - MedPix (2009)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Postpartum Cerebral Angiopathy

History: 34-year-old African American G1P1 female with no significant medical history presents to the ER four days postpartum complaining of the “worst headache of her life” on the right-sided of her head.

Findings: CT: Axial Noncontrast CT of the Brain showed an acute SAH in the right frontal lobe brain. Cerebral angiogram: Lateral projection of the right cerebral angiogram demonstrated irregular variable caliber in cortical vessels in the right MCA distribution. MRI/MRA: Diffusion weight image, Apparent Diffusion Coefficient MRI, and T2-weighted images of brain demonstrate an acute infarct in the right mid-posterior cerebellar in the superior cerebellar vascular territory. Axial FLAIR MRI of the brain showed multiple nonspecific small foci of increased FLAIR signal within the anterior aspects of the external capsule bilaterally. 3D time of flight MRA of the cerebral arteries demonstrated MCA cortical vessel caliber variation.

Ddx: Postpartum Cerebral Angiopathy Preeclampsia Pseudoanyeurysm Primary Cerebral Vasculitis Other secondary Cerebral Vasculitis: • Polyarteritis nodosa • Giant cell arteritis • Takayasu’s arteritis • Wegener’s granulomatosis • SLE • RA • Behcet’s syndrome • Lyme Disease • Illicit drugs  cocaine  heroin  amphetamines • Sarcoidosis

Dxhow: Contrast Catheter Cerebral Angiography & MRI/MRA

Exam: BP: 111/63, HR: 98, RR: 18, T: 97.6 °F, HT: 63 in, WT: 158 lbs, BMI: 27.99. No focal neurological findings found on exam CSF: large amount of RBC with xanthochromia ESR: 56 mm/hour No proteinuria on UA Otherwise Normal exam and labs

No MeSH data available.


T2 MRI of the head showing an acute infarct in the left mid-posterior cerebellum in the superior cerebellar vascular territory.
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MPX2407_synpic48722: T2 MRI of the head showing an acute infarct in the left mid-posterior cerebellum in the superior cerebellar vascular territory.


Postpartum Cerebral Angiopathy

Tillman BGT - MedPix (2009)

T2 MRI of the head showing an acute infarct in the left mid-posterior cerebellum in the superior cerebellar vascular territory.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2407&req=5

MPX2407_synpic48722: T2 MRI of the head showing an acute infarct in the left mid-posterior cerebellum in the superior cerebellar vascular territory.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Postpartum Cerebral Angiopathy

History: 34-year-old African American G1P1 female with no significant medical history presents to the ER four days postpartum complaining of the “worst headache of her life” on the right-sided of her head.

Findings: CT: Axial Noncontrast CT of the Brain showed an acute SAH in the right frontal lobe brain. Cerebral angiogram: Lateral projection of the right cerebral angiogram demonstrated irregular variable caliber in cortical vessels in the right MCA distribution. MRI/MRA: Diffusion weight image, Apparent Diffusion Coefficient MRI, and T2-weighted images of brain demonstrate an acute infarct in the right mid-posterior cerebellar in the superior cerebellar vascular territory. Axial FLAIR MRI of the brain showed multiple nonspecific small foci of increased FLAIR signal within the anterior aspects of the external capsule bilaterally. 3D time of flight MRA of the cerebral arteries demonstrated MCA cortical vessel caliber variation.

Ddx: Postpartum Cerebral Angiopathy Preeclampsia Pseudoanyeurysm Primary Cerebral Vasculitis Other secondary Cerebral Vasculitis: • Polyarteritis nodosa • Giant cell arteritis • Takayasu’s arteritis • Wegener’s granulomatosis • SLE • RA • Behcet’s syndrome • Lyme Disease • Illicit drugs  cocaine  heroin  amphetamines • Sarcoidosis

Dxhow: Contrast Catheter Cerebral Angiography & MRI/MRA

Exam: BP: 111/63, HR: 98, RR: 18, T: 97.6 °F, HT: 63 in, WT: 158 lbs, BMI: 27.99. No focal neurological findings found on exam CSF: large amount of RBC with xanthochromia ESR: 56 mm/hour No proteinuria on UA Otherwise Normal exam and labs

No MeSH data available.