Lazurenko V. V., Abdullaieva N. A.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The aim of the study was to analyze the literature on cerebrovascular disorders in pregnant women and to present a case of acute cerebrovascular disorders in a woman in labor. There are pathophysiological reasons for the increased risk of both ischemic and hemorrhagic strokes during pregnancy. Hemorrhagic stroke is relatively more common during pregnancy and carries a higher risk of disease than ischemic stroke. In particular, hypertensive diseases of pregnancy, such as preeclampsia / eclampsia, rupture of vascular malformations, aneurysms can lead to subarachnoid hemorrhage or intracerebral hemorrhage. The risk of venous thrombosis increases during pregnancy, and it may increase the risk of ischemic stroke due to paradoxical emboli or cerebral vein thrombosis. In addition, pregnancy, which is a prothrombotic condition, is also associated with relative hyperlipidemia and hypertension. Intracranial aneurysm rupture is still the most common cause of subarachnoid hemorrhage during pregnancy and the postpartum period. The incidence of intracranial hemorrhage from a ruptured brain aneurysm during pregnancy is low, but still remains the most common cause of subarachnoid hemorrhage during pregnancy and in the postpartum period. In the studied clinical case, there occurred an acute cerebrovascular accident in a young woman of 32 years old on the background of good health, which caused subarachnoid hemorrhage. The patient underwent endovascular embolization of a dual arteriovenous fistula from the left vertebral artery. Conclusion. To prevent the development of acute cerebrovascular disorders in women in labor, when registering pregnant women, a doctor should pay close attention to her heredity and chronic diseases. If various vascular abnormalities are suspected, the doctor should appoint additional tests to identify abnormalities, followed by preventive measures and treatment. In case of acute cerebrovascular accident, endovascular embolization is a safe treatment.

pregnancy, cerebrovascular pathology, endovascular embolization.

1. Guida M, Altieri R, Palatucci V, Visconti F, Pascale R, Marra M, et al. Aneurysmal subarachnoid haemorrhage in pregnancy: a case series. Transl Med UniSa 2012 Jan 18;2:59-63.
2. Kim EJ, Vermeulen S, Li FJ, Newell DW. A review of cerebral arteriovenous malformations and treatment with stereotactic radiosurgery. Journal Translational Cancer Research. 2014;3(4):399-410. DOI: 10.3978/j.issn. 2218-676X.2014.07.07.
3. Zhang S, Zhang J, Ren Q, He M, Shan B, Zeng Y, et al. Prognostic role of neutrophil-to-lymphocyte ratio in patients with brain arteriovenous malformations. Oncotarget. 2018;9(1):1259-1266.
4. Sackey FA, Pinsker NR, Baako BN. Highlights on Cerebral Arteriovenous Malformation Treatment Using Combined Embolization and Stereotactic Radiosurgery: Why Outcomes are Controversial? Cureus. 2017;9(5):1266.
5. Syvokonyuk VV, Lituchyy VM, Savchuk DM. Povidomlennya pro klinichnyy vypadok gemoragichnogo insultu u vagitnoyi vnaslidok rozryvu arteriovenoznoyi malformatsiyi mozochka. Shpytalna khirurgiya. Zhurnal imeni L.Ya. Kovalchuka. 2016;1:112-5. [in Ukrainian].
6. Ban L, Abdul Sultan A, Stephansson O, Tata LJ, Sprigg N, Nelson-Piercy C, et al. The incidence of first stroke in and around pregnancy: A population-based cohort study from Sweden. European Stroke Journal. 2017;2(3):250-6. DOI: 10.1177/2396987317706600.
7. Peschillo S, Caporlingua A, Colonnese C, Guidetti G. Brain AVMs: An Endovascular, Surgical, and Radiosurgical Update. Scientific World Journal. 2014;2014:834931. DOI: 10.1155/2014/834931.
8. McLean K, Cushman M. Venous thromboembolism and stroke in pregnancy. Hematology Am Soc Hematol Educ Program. 2016 Dec 2;2016(1):243-50. DOI: 10.1182/asheducation-2016.1.243.
9. Onat T, Daltaban İS, Tanın ÖŞ, Kara M. Rupture of cerebral aneurysm during pregnancy: a case report. Turk J Obstet Gynecol. 2019 Jun;16(2):136-9. DOI: 10.4274/tjod.galenos.2019.23080.
10. Del Zotto E, Giossi A, Volonghi I, Costa P, Padovani A, Pezzini A. Ischemic Stroke during Pregnancy and Puerperium. Stroke Res Treat. 2011 Jan 27;2011:606780. DOI: 10.4061/2011/606780.
11. Dovgyy IL, Svyrydova NK. Reabilitatsiya khvorykh, yaki perenesly ishemichnyy insult metodamy ozonoterapiyi, kineziterapiya, fizioterapiyi i akupunktury. Skhidno-yevropeyskyy nevrologichnyy zhurnal. 2016;6(12):4-9. [in Ukrainian].
12. Cheng SJ, Chen PH, Chen LA, Chen CP. Stroke during pregnancy and puerperium: clinical perspectives. Taiwan J Obstet Gynecol. 2010 Dec;49(4):395-400. DOI: 10.1016/S1028-4559(10)60088-5.
13. Kuznyetsov VV, Yegorova MS, Larina NV. Genetychni aspekty ishemichnogo insultu. Zhurnal nevrologiyi im. B.M. Mankovskogo. 2018;6(1):69-80. [in Ukrainian].
14. Glugovska SV. Porushennya mozkovogo krovoobigu v zhinok z nadmirnoyu masoyu tila ta ozhyrinnyam. Mizhnarodnyy endokrynologichnyy zhurnal. 2016;8(80):20-3. [in Ukrainian].

«Bulletin of problems biology and medicine» Issue 1 (163), 2022 year, 141-145 pages, index UDK 616.831-005:618.3-06

10.29254/2077-4214-2022-1-163-141-145