on June 5, 2008
Published online before print June 5, 2008, doi: 10.1161/STROKEAHA.107.510107
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Submitted on November 15, 2007
From the Department of Neurology (M.A., M.C.-J., C.S., A.D., A.V., K.B., M.G.B.) and the Headache Emergency Centre (A.D.), Assistance Publique, Hôpitaux de Paris, University Hospital Lariboisière, Paris, France; and the Department of Neurology (M.A.), University Hospital, Berne, Switzerland. * To whom correspondence should be addressed. E-mail: marcel.arnold{at}insel.ch.
Background and Purpose—Cervicocephalic artery dissection (CAD) after childbirth is rare. The objective of this study was to determine differences between postpartum and nonpostpartum CAD. Methods—We compared consecutive patients with postpartum CAD with a control group of women with nonpostpartum CAD. Results—Of 245 patients with CAD, 102 women <50 years (6 with postpartum CAD and 96 with nonpostpartum CAD) were identified. Vascular risk factors and presenting characteristics did not differ significantly between postpartum CAD and nonpostpartum CAD women. By contrast, patients with postpartum CAD had more often coexisting conditions such as reversible cerebral vasoconstriction syndrome (2 of 6 versus 2 of 96; P=0.017), reversible posterior leukoencephalopathy syndrome (2 of 6 versus one of 96; P=0.009), and subarachnoid hemorrhage without signs of intracranial extension of CAD (2 of 6 versus zero of 96; P=0.003). Conclusion—CAD and associated conditions should be looked for in women with unusual headache after childbirth.
Accepted on December 13, 2007
Postpartum Cervicocephalic Artery Dissection
Marcel Arnold MD*;
Key words: stroke • childbirth • dissection • postpartum angiopathy • reversible cerebral vasoconstriction syndrome
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