Submission to VIJ 2024-08-21
Keywords
- Pregnancy, Postpartum, Neck Pain, Stroke, Cervical Artery Dissection (CeAD)
Abstract
Objective: Stroke among young and elderly people is frequently caused by cervical artery dissection (CeAD). A rupture in any one or more blood vessel layers of tissue results in cervical artery detachment. Information for the causative factor of one-fifth of ischemic stroke patients is available from case reports and case reviews. CeAD is rare during pregnancy and in the early postpartum period. In addition, other risk factors have been suggested, such as infection, migraine, hyperhomocysteinaemia, and the 677TT genotype of the 5,10-methylenetetrahydrofolate reductase gene (MTHFR 677TT).
Limitation: A lack of neurological diseases during pregnancy and the postpartum period provides major obstacles for both the mother and child. The restricted therapeutic choices might impair care and complicate management. Multidisciplinary care is frequently required to achieve a delicate equilibrium between the health of the mother and the risk of foetal hazards.
Method: This systematic review with a systematically registered protocol was the strategy to study the clinical presentation, management, and outcome of this situation. For inclusion, 40 studies were found through language-free searches on Google Scholar and PubМed.
Results: The key factors of the greatest incidence found were migraine, hyperlipidemia, connective tissue diseases, HELLP syndrome, preeclampsia or eclampsia, and the protracted second phase of labor. The most frequent complaint was a headache with soreness in the neck. Anticoagulant medication, anti-platelet agents, and endovascular procedures were among the acute medical interventions.
Conclusion: This research emphasizes the value of efficient, all-encompassing care and raised knowledge to optimize results in pregnant women.