Rare Stroke Affects Pregnant and Postpartum Women

Cerebral venous thrombosis affects many women postpartum; diagnosis and management discussed

FRIDAY, Feb. 4 (HealthDay News) -- The American Heart Association (AHA) has compiled a series of evidence-based recommendations for the diagnosis, management, and treatment of cerebral venous thrombosis (CVT), and specifically for its management during pregnancy and postpartum, detailed in a statement published online Feb. 3 in Stroke.

Gustavo Saposnik, M.D., from the University of Toronto, and colleagues from the AHA Stroke Council's Scientific Statement Oversight Committee, reviewed recent literature on CVT, a rare type of stroke, with a focus on published materials since 1966. The AHA levels-of-evidence grading algorithm was used to assess the evidence, and it formed the basis of their recommendations.

The researchers found increased incidences of CVT in women who are pregnant or taking oral contraceptives, and people aged 45 or younger. Women in the last trimester and up to four weeks after giving birth are also at high risk for CVT; up to 73 percent of CVTs in women occur in the immediate postpartum period. To diagnose and manage CVT, the committee recommends a blood test for prothrombotic factor for patients with suspected CVT, and screening patients for predisposing factors. The statement includes a process to assist clinicians with the diagnosis and management of CVT, including magnetic resonance imaging to confirm suspected CVT, coagulation therapy, and other options, such as surgery or endovascular treatment if necessary.

"Through a process of innovative research and systematic evaluation, diagnosis, management, and therapeutic alternatives will continue to evolve and consequently lead to better outcomes for patients with CVT," the authors write.

Several statement authors and reviewers disclosed financial relationships with the pharmaceutical industry.

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