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INTRODUCTIONNormal pregnancy, although associated with considerable metabolic and endocrine changes, is usually well tolerated by a healthy nervous system (Helen, 1962). The incidence of neurological disorders in pregnancy and puerperium was fairly high (Gupta and Rohatgi et al, 2006). The range of neurological conditions affecting women of reproductive age is extremely broad (Goldstein, 1986 and Donaldson, 1989).Diverse pathologic conditions affect the central nervous system and pituitary gland during pregnancy and the puerperium. Some are specific to physiologic process of reproduction (eg, eclampsia, postpartum cerebral angiopathy, Sheehan syndrome, lymphocytic adenohypophysitis) Others are nonspecific but occur more often in pregnant women (eg, cerebral infarction, dural venous thrombosis, pituitary apoplexy). (Imad and Harjot et al, 2007).There is considerable overlap of the clinical features of different diseases entities affecting the central nervous system.Cerebrovascular complications: are classified into (ischemic infarction, subarachnoid hemorrhage, eclamptic encephalopathy, postpartum cerebral angiopathy, and cerebral venous thrombosis).The neuroendocrine disorders of pituitary gland: are classified in to (pituitary apoplexy, Sheehan syndrome, and lymphocytic adenohypophysitis).Neoplastic disorders: include (pituitary adenomas, primary CNS tumors, and intracranial metastatic disease (Imad and Harjot et al, 2007).The obstetrician may be concerned with neurological disorders either because they arise during pregnancy, or because pregnancy occurs in a woman who already suffers from some disease of the central nervous system (Josephine, 1962).Pregnancy may affect the course of pre-existing neurological disorders such as epilepsy. A secondary neurological disorder (e.g. encephalopathy) can affect a pregnant patient with a non neurological medical disease (Gupta and Rohatgi et al, 2006).There is a general tendency for delayed diagnosis of uncommon but serious conditions during pregnancy because of a reluctance to perform imaging studies. Recognition of the characteristic imaging findings in earlier use of imaging will result in fewer delayed diagnosis. Modalities such as CT scanning is superior in the extent of the abnormality however, it uses ionizing radiation, and may require intravenous injection of contrast material (Rooholamini et al, 1993).In eclampsia CT scans may demonstrate areas of low attenuation in cerebral cortex, white matter, basal ganglia (Lewis et al, 1998).MR imaging is the study of choice for the detection of neurologic complications of pregnancy (Rooholamini et al, 1993)MR imaging is more sensitive than CT in early detection of thrombosis and more accurate in depicting the extent and complications of cerebrovascular thrombosis.MR venography has been found to be reliable in the diagnosis of dural sinus thrombosis but is susceptible to error in cases involving velocity- encoding mismatch or slow flow (Johason and Fram, 1992).More recently, CT venography has shown promise in diagnosing dural sinus thrombosis and has been found to have a sensitivity equal to that of MR venography (Ozsvath et al, 1997).Aim of the work1. Describe the pathophysiologic features of these disorders and discuss how they correlate with the imaging features. The aim of this essay is to List the various cerebrovascular, neuroendocrine, and neoplastic disorders affecting the central nervous system during pregnancy and the puerperium.23. To illustrate and discuss the various neuroimaging findings of maternal neurologic complications that occur during pregnancy and the immediate postpartum period and the imaging findings as demonstrated on [computed tomography, magnetic resonance imaging, and cerebral angiography].
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