CT & MR Imaging of Neurological Diseases in Pregnancy and Puerperium

Pregnancy and puerperium is an important phase in medical sciences where unforseen circumstances can develop at any time. Some of the neurological signs and symptoms are indicative of impending risk while others are of no significance. This is where neuro imaging helps in identifying neurological disorders as well as in correlating them with the clinical presentations. Headache has been found to be clinically significant because it is usually associated with neurological disorders. So our objective is to establish the usefulness of imaging by CT and MRI in pregnancy and puerperium. This helps in advocating better treatment options and thereby have a good outcome. OBJECTIVE To know the prevalence of disorders affecting the central nervous system during pregnancy and puerperium To understand the neuroimaging findings of the various neurological disorders in pregnancy and puerperium To evaluate the significance of CT &MR imaging in diagnosis neurological disorders in pregnancy and puerperium. To assess the usefulness of CT and MR imaging in determining the treatment modalities MATERIALS From August 2013 to august 2014, around 50 consecutive patients who presented with neurological signs and symptoms in Coimbatore Medical College Hospital, Coimbatore were selected for the study. DESIGN: Observational study SETTING: Department of Obstetrics and Gynaecology and Department of Radiodiagnosis. STUDY METHOD: 50 consecutive patients who were selected included both pregnant women and those in the puerperium phase with neurological signs and symptoms. History was elicited from these patients using the questionnaire that was framed for this purpose. Following this they were subjected to CT and MRI based on the indications. The prime motive is to make a relevant diagnosis based on imaging findings. RESULTS The study showed that cerebral venous thrombosis is the commonest neurological entity encountered in Coimbatore Medical College Hospital in pregnant women followed by Posterior reversible encephalopathy syndrome. This is quite contrary to the scenario in the developed countries. It can be attributed to the environmental conditions, traditional practices as well as the socioeconomic status of the general population in developing countries like India. Four cases of mortality with hemorrhagic infarcts due to venous thrombosis were recorded during the study period .Sudden onset of severe headache whether in antepartum women or young mothers in the immediate postpartum is the commonest symptom that correlated with positive imaging findings. CONCLUSION Neurological symptoms are not uncommon during pregnancy and puerperium. While most symptoms turn out to be benign, in some patients they may indicate serious underlying problems. Use of prompt and appropriate imaging modality potentially helps to diagnose serious illness earlier and more accurately, thus helping the obstetrician to institute appropriate treatment strategies. This has a definite impact in reducing maternal morbidity and mortalit