Postpartum cerebral angiopathy treated with intra-arterial nicardipine and intravenous immunoglobulin
| Autor: | Italo Linfante, Edgar A. Samaniego, Guilherme Dabus, Gillian M Generoso, Karel Fuentes, Francesca Tari-Capone |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Vasodilator Agents Cerebral arteries Nicardipine Angiopathy Lethargy Medicine Humans Infusions Intra-Arterial Nimodipine business.industry Postpartum Period Immunoglobulins Intravenous Vasospasm General Medicine medicine.disease Pathophysiology Radiography Cerebrovascular Disorders Treatment Outcome Anesthesia Surgery Female Neurology (clinical) medicine.symptom business Vasoconstriction medicine.drug |
| Zdroj: | Journal of neurointerventional surgery. 5(3) |
| ISSN: | 1759-8486 |
| Popis: | Postpartum cerebral angiopathy (PCA) is a rare vasoconstriction syndrome that can lead to severe disability and death. The pathophysiology of PCA is unknown. A case of a 39-year-old woman who developed PCA 3 days after twin delivery is reported. She presented with right hemiparesis, aphasia and lethargy. Imaging studies demonstrated severe segmental narrowing of multiple cerebral arteries comprising the anterior and posterior circulations. She continued to deteriorate despite induced hypertension, immunosuppression, intravenous magnesium and oral nimodipine. Intra-arterial administration of nicardipine on three consecutive occasions reversed the angiographic vasospasm and led to symptom resolution. Definite improvement occurred after a 5 day course of intravenous immunoglobulin (IVIg). The patient described in this report developed recalcitrant PCA-induced vasospasm which resolved with endovascular administration of nicardipine and immunotherapy with IVIg. |
| Databáze: | OpenAIRE |
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