Neurological Emergencies During Pregnancy - 23/04/21

Doi : 10.1016/j.ncl.2021.02.008

Elizabeth Macri, MD ^a , Diana Greene-Chandos, MD, FNCS ^b,^⁎
^a Department of Neurology, University of New Mexico, MSC10 5620, 1 University of New Mexico, Albuquerque, NM 87131, USA
^b Neurosciences Critical Care Fellowship, Department of Neurology, University of New Mexico; MSC10 5620, 1 University of New Mexico, Albuquerque, NM 87131, USA

^∗Corresponding author.

Résumé

This article serves as a comprehensive review of neurologic emergencies in pregnancy. Common initial presentations of neuroemergencies are reviewed with a clinical algorithm. Neurovascular disorders in pregnancy are reviewed, including acute ischemic strokes with data on tPA and thrombectomy; cerebral venous sinus thrombosis diagnosis and management; posterior reversible encephalopathy syndrome management; reversible cerebral vasoconstriction syndrome; and intracerebral hemorrhage. Attention is paid to management of cerebral edema and safety of osmotic therapies. A review of seizures in pregnancy is provided, including new-onset causes and decreased seizure thresholds. For status epilepticus, a low teratogenicity risk medication protocol in pregnancy is provided.

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Keywords : Neurocritical care in pregnancy, Stroke in pregnancy, Seizures in pregnancy, Intracerebral hemorrhage in pregnancy, Cerebral venous sinus thrombosis, Posterior reversible encephalopathy syndrome, Neuroimmune disorders in pregnancy, Brain death in pregnancy