Gravidez, puerpério e doença vascular cerebral

Fukujima, Márcia Maiumi; Oliveira, Roberto de Magalhães Carneiro de; Shimazaki, Jean Carlos; Lima, José Geraldo de Camargo

doi:10.1590/S0004-282X1996000200006

Resumos

Foram estudadas seis pacientes com doenças cerebrovasculares no período gravídico-puerperal. Uma apresentou hemorragia cerebral, três apresentaram infarto cerebral e duas trombose de seio venoso cerebral. A associação de fatores clínicos ao estado peculiar produzido pela gravidez parece ter resultado nas doenças apresentadas, com especial ênfase à doença de Chagas presente em todos os infartos cerebrais.

gravidez; puerpério; acidente vascular cerebral; infarto cerebral; hemorragia cerebral; trombose venosa cerebral; doença de Chagas

Six patients who presented cerebrovascular disease during puerperium or pregnancy were studied. One of them presented hemorrhagic stroke caused by intracerebral bleeding due to pre-eclampsia. Three patients presented ischemic stroke, they all had positive serologic reactions for Chagas' disease, but only two of them had clinical cardiopathy; one of these patients had anticardiolipin antibody. The other two patients presented cerebral venous thrombosis of sagittal sinus. Both were smokers and one of them used oral contraceptive. We emphasize the importance of clinical investigation to seek for the common causes of cerebrovascular disease in young people, with special attention to Chagas disease in Brazil.

pregnancy; puerperium; stroke; cerebral infarction; cerebral hemorrhage; cerebral venous thrombosis; Chagas¹ disease

Gravidez, puerpério e doença vascular cerebral

Pregnancy, puerperium and cerebrovascular disease

Márcia Maiumi Fukujima^I; Roberto de Magalhães Carneiro de Oliveira^I; Jean Carlos Shimazaki^II; José Geraldo de Camargo Lima^III

^IMestre em Neurologia pela EPM-UNIFESP

^IINeurologista pela EPM-UNIFESP

^IIIProfessor Titular e Chefe da Disciplina de Neurologia da EPM-UNIFESP

RESUMO

Foram estudadas seis pacientes com doenças cerebrovasculares no período gravídico-puerperal. Uma apresentou hemorragia cerebral, três apresentaram infarto cerebral e duas trombose de seio venoso cerebral. A associação de fatores clínicos ao estado peculiar produzido pela gravidez parece ter resultado nas doenças apresentadas, com especial ênfase à doença de Chagas presente em todos os infartos cerebrais.

Palavras chave: gravidez, puerpério, acidente vascular cerebral, infarto cerebral, hemorragia cerebral, trombose venosa cerebral, doença de Chagas.

ABSTRACT

Six patients who presented cerebrovascular disease during puerperium or pregnancy were studied. One of them presented hemorrhagic stroke caused by intracerebral bleeding due to pre-eclampsia. Three patients presented ischemic stroke, they all had positive serologic reactions for Chagas' disease, but only two of them had clinical cardiopathy; one of these patients had anticardiolipin antibody. The other two patients presented cerebral venous thrombosis of sagittal sinus. Both were smokers and one of them used oral contraceptive. We emphasize the importance of clinical investigation to seek for the common causes of cerebrovascular disease in young people, with special attention to Chagas disease in Brazil.

Key words: pregnancy, puerperium, stroke, cerebral infarction, cerebral hemorrhage, cerebral venous thrombosis, Chagas¹ disease.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 12-dezembro-1995.

Estudo realizado na Escola Paulista de Medicina (EPM) da Universidade Federal de São Paulo (UNIFESP)

Dra. Mareia Maiumi Fukujima - Disciplina de Neurologia Universidade Federal de São Paulo - Rua Botucatu 740 - 04023-900 São Paulo SP - Brasil - Fax 011 5755240. E-Mail: maiumi@sti.com.br

1. Ameri A, Bousser MG. Cerebral venous trhombosis. Neurologic Clinics 1992; 10:87-111.
2. Banerjee AK, Varma M, Vasista RK, Chopra JS. Cerebrovascular disease in north-west India: a study of necropsy material. J Neurol Neurosurg Psychiatry 1989;52:512-515.
3. Bevan H, Sharma K, Bradley W. Stroke in young adults. Stroke !990;21:382-386.
4. Donaldson JO, Lee NS. Arterial and venous stroke associated with pregnancy. Neurologic Clinics 1994; 12:583-599.
5. Finley BE. Coagulopatia aguda no gravidez. Clínicas Médicas da America do Norte 1989;73: 793-814.
6. Futrell N, Millikan C. Neurologic disorders of pregnancy: connective tissue. Neurologic Clinics 1994;12:527-539.
7. Hainline B. Neurologic complications of pregnancy: headache. Neurologic Clinics 1994; 12:443-460.
8. Hoicomb WL Jr, Petrie RH. Cerebrovascular emergencies in pregnancy. Clin Obstetr Gyn 1990;33:467-472.
9. Lockwood CJ, Rand JH. The immunobiology and obstetrical consequences of antiphospholipid antibodies. Obst Gyn Survey 1994;49:432-441.
10. Raps EC, Galetta SL, Broderick M, Atlas SW. Delayed peripartum vasculopathy: cerebral eclampsia revisited. Ann Neurol 1993;33:222-225.
11. Sharshar T, Lamy C, Mas JL. Incidence and causes of strokes associated with pregnancy and puerperium: a study in public hospitals of He de France. Stroke 1995;26:930-936.
12. Simolke GA, Cox SM, Cunningham G. Cerebrovascular accidents complicating pregnancy and the puerperium. Obstetr Gynecol 1991;78:37-42.
13. Srinivasan K. Ischemic cerebrovascular disease in the young: two common causes in India. Stroke 1984; 15:733-737.
14. WieberDO. Ischemic cerebrovascular complications of pregnancy. Arch Neurol 1985;12:1106-1113.
15. Wiebers DO, Whisnant JP. The incidence of stroke among pregnant women in Rochester, Minn, 1955 through 1979. JAMA 1985;254:3055-3057.
16. Wilterdink JL, Easton JD. Cerebral ischemia. In Devinsky O, Feldmann E, Hainline B. Neurological complications of pregnancy. New York: Raven Press, 1994: 1-11.
17. Wilterdink JL, Feldmann E. Cerebral hemorrhage. In Devinsky O, Feldmann E, Hainline B (eds). Neurological complications of pregnancy. New York: Raven Press, 1994: 13-23.

Datas de Publicação

Publicação nesta coleção
06 Dez 2010
Data do Fascículo
Jun 1996

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Ameri A, Bousser MG. Cerebral venous trhombosis. Neurologic Clinics 1992; 10:87-111.

[2] 2. Banerjee AK, Varma M, Vasista RK, Chopra JS. Cerebrovascular disease in north-west India: a study of necropsy material. J Neurol Neurosurg Psychiatry 1989;52:512-515.

[3] 3. Bevan H, Sharma K, Bradley W. Stroke in young adults. Stroke !990;21:382-386.

[4] 4. Donaldson JO, Lee NS. Arterial and venous stroke associated with pregnancy. Neurologic Clinics 1994; 12:583-599.

[5] 5. Finley BE. Coagulopatia aguda no gravidez. Clínicas Médicas da America do Norte 1989;73: 793-814.

[6] 6. Futrell N, Millikan C. Neurologic disorders of pregnancy: connective tissue. Neurologic Clinics 1994;12:527-539.

[7] 7. Hainline B. Neurologic complications of pregnancy: headache. Neurologic Clinics 1994; 12:443-460.

[8] 8. Hoicomb WL Jr, Petrie RH. Cerebrovascular emergencies in pregnancy. Clin Obstetr Gyn 1990;33:467-472.

[9] 9. Lockwood CJ, Rand JH. The immunobiology and obstetrical consequences of antiphospholipid antibodies. Obst Gyn Survey 1994;49:432-441.

[10] 10. Raps EC, Galetta SL, Broderick M, Atlas SW. Delayed peripartum vasculopathy: cerebral eclampsia revisited. Ann Neurol 1993;33:222-225.

[11] 11. Sharshar T, Lamy C, Mas JL. Incidence and causes of strokes associated with pregnancy and puerperium: a study in public hospitals of He de France. Stroke 1995;26:930-936.

[12] 12. Simolke GA, Cox SM, Cunningham G. Cerebrovascular accidents complicating pregnancy and the puerperium. Obstetr Gynecol 1991;78:37-42.

[13] 13. Srinivasan K. Ischemic cerebrovascular disease in the young: two common causes in India. Stroke 1984; 15:733-737.

[14] 14. WieberDO. Ischemic cerebrovascular complications of pregnancy. Arch Neurol 1985;12:1106-1113.

[15] 15. Wiebers DO, Whisnant JP. The incidence of stroke among pregnant women in Rochester, Minn, 1955 through 1979. JAMA 1985;254:3055-3057.

[16] 16. Wilterdink JL, Easton JD. Cerebral ischemia. In Devinsky O, Feldmann E, Hainline B. Neurological complications of pregnancy. New York: Raven Press, 1994: 1-11.

[17] 17. Wilterdink JL, Feldmann E. Cerebral hemorrhage. In Devinsky O, Feldmann E, Hainline B (eds). Neurological complications of pregnancy. New York: Raven Press, 1994: 13-23.