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Cervical artery dissection in postpartum women after cesarean and vaginal delivery

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dc.contributor.authorUrrutia, Francisca
dc.contributor.authorMazzon, Enrico
dc.contributor.authorBrunser, Alejandro
dc.contributor.authorDíaz, Violeta
dc.contributor.authorCalderon, Juan
dc.contributor.authorStecher, Ximena
dc.contributor.authorBernstein, Tomas
dc.contributor.authorZuñiga, Paulo
dc.contributor.authorSchilling, Andrea
dc.contributor.authorMuñoz, Paula
dc.date.accessioned2023-05-05T17:59:28Z
dc.date.available2023-05-05T17:59:28Z
dc.date.issued2022
dc.description.abstractBackground and aims: Cervical artery dissection (CAD) is an infrequent but potentially disabling and fatal disease, accounting for up to 25 % of strokes in young adults. Pregnancy-related hormonal changes and increased hemodynamic stress on artery walls during vaginal delivery have been associated to CAD. We aim to describe a series of women presenting CAD during postpartum (PP) after cesarean and vaginal delivery. Methods: CAD women admitted to one hospital in Santiago, Chile, between July 2018 and October 2020 were included in a prospective cohort. Demographic, clinical and imaging data were registered for the PP group. Results: Sixty-seven women were diagnosed with CAD, from which 10 were PP. Seven women had cesarean section and 3 had vaginal delivery. They presented CAD related symptoms after a median of 10.5 (IQR 5-15) days from delivery. All of them had headache as initial symptom, 9 presented cervical pain and 8 had a family history of stroke. Four patients presented preeclampsia during pregnancy. Acute treatment consisted mostly in antiplatelet agents and analgesics. None of these patients had a CAD related stroke. Demographic, clinical and imaging characteristics of these women with CAD during PP are described. Conclusions: This case series underpins the importance of clinical suspicion of CAD after delivery, highlighting the fact that CAD is not limited to women with vaginal delivery, thus alternative causes beyond acute hemodynamic stress could be involved. Further research is required to determine genetic components, along with deeper knowledge of modulating factors related to CAD in this setting.
dc.identifier.citationUrrutia F, Mazzon E, Brunser A, Diaz V, Calderon JF, Stecher X, Bernstein T, Zuñiga P, Schilling A, Muñoz Venturelli P. Cervical Artery Dissection in Postpartum Women after Cesarean and Vaginal Delivery. J Stroke Cerebrovasc Dis. 2022 Aug;31(8):106572. doi: 10.1016/j.jstrokecerebrovasdis.2022.106572
dc.identifier.doihttps://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106572
dc.identifier.urihttps://repositorio.udd.cl/handle/11447/7469
dc.language.isoen
dc.relation.projectFondecyt
dc.titleCervical artery dissection in postpartum women after cesarean and vaginal delivery
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
dspace.entity.typePublication

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