title: Postpartum angiopathy associated with reversible borderzone ischemia.
abstract: A 32-year-old woman developed a headache, seizures, and stupor on postpartum day 8. An initial diagnosis of possible encephalitis was made considering the presence of fever, neck stiffness, and abnormal CSF findings. MRI demonstrated hyperintense signals consistent with bilateral borderzone areas. MRA showed severe proximal narrowing of anterior, middle, and posterior cerebral arteries bilaterally. The patient recovered completely over 2 weeks, and repeated MRI and MRA scans were normal. Reversible vasoconstrictions have been known to occur during puerperium, and the clinical symptoms of our patient resembled such cases. Prior reports attributed these cases of postpartum angiopathy to capillary leakage and edema resulting in leukoencephalopathy. Our case suggests reversible borderzone ischemia as an additional pathological process.
authors.affiliation: Department of Neurology, Osaka Saiseikai Nakatsu Hospital, Nakatsu, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Toru
authors.initials: T
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D002545:Brain Ischemia / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D011644:Puerperal Disorders; D011859:Radiography; D014652:Vascular Diseases / Q000150:complications