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Postpartum Cerebral Angiopathy in a Patient With Chronic Migraine With Aura
Author(s) -
Modi Mala,
Modi Girish
Publication year - 2000
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1046/j.1526-4610.2000.040008677.x
Subject(s) - medicine , reversible cerebral vasoconstriction syndrome , angiopathy , migraine , aura , anesthesia , cerebral arteries , cerebral amyloid angiopathy , eclampsia , cerebral edema , migraine with aura , stroke (engine) , pregnancy , vasoconstriction , cardiology , dementia , mechanical engineering , disease , biology , engineering , genetics , diabetes mellitus , endocrinology
A 25‐year‐old woman with a history of chronic severe migraine with aura presented in an apoplectic state 1 week after the delivery of her third child. She developed a severe headache and within hours lapsed into a coma. A CT scan of the brain showed cerebral edema and an occipital hemorrhage. A four‐vessel angiogram showed diffuse arterial narrowing of all the intracranial vessels with segmental narrowing of the suprasellar portion of the internal carotid arteries bilaterally. She had no risk factors for stroke or vasculitis. Her pregnancy and delivery were uneventful with no preeclampsia or eclampsia. Apart from ergometrine at the time of the delivery, no vasoconstrictor drugs were used. She recovered spontaneously. Serial CT scans of the brain demonstrated resolution of the edema and hemorrhage with the development of cortical and watershed infarcts. A repeat cerebral angiogram was normal. She was, therefore, diagnosed as having suffered from postpartum cerebral angiopathy, a form of reversible cerebral vasoconstriction, called the Call or Call‐Fleming syndrome. The relationship between migraine and postpartum angiopathy in the development of reversible cerebral vasoconstriction is discussed.