Penyakit Serebrovaskuler pada Preeklampsia

  • Dewi Yulianti Bisri Faculty of Medicine Universitas Padjadjaran Bandung
  • Tatang Bisri Faculty of Medicine Universitas Jend. Ahmad Yani Cimahi Bandung, Indonesia
Keywords: Preeklampsia, Wanita hamil, penyakit serebrovaskular, Stroke

Abstract

Preeklamsia, penyakit hipertensi yang mempengaruhi 5% hingga 8% kehamilan, adalah gangguan multisistem, dengan disfungsi pembuluh darah menjadi pusat penyakit. Pembuluh darah otak ibu sangat rentan terhadap efek samping preeklampsia. Komplikasi serebrovaskular jangka pendek dan jangka panjang dari preeklampsi termasuk sindrom ensefalopati reversibel posterior (posterior reversible encephalopathy syndrome/PRES), sindrom vasokonstriksi serebral reversibel (reversible cerebral vasoconstriction syndrome/RCVS), stroke hemoragik dan iskemik, penyakit vasokonstriksi serebral, dan demensia vaskular. Gangguan serebrovaskular akut, termasuk PRES, RCVS, stroke iskemik dan hemoragik, dan trombosis sinus vena serebral (cerebral venous sinus thrombosis/CVST), adalah komplikasi preeklampsia yang ditakuti yang dapat mengakibatkan kecacatan ibu permanen atau kematian. Risiko penyakit serebrovaskular akut pada kehamilan yang dipersulit oleh preeklampsi sebesar 1 dari 500 persalinan; sebagai perbandingan, risiko keseluruhan penyakit serebrovaskular akut terkait kehamilan adalah ≈30 per 100.000 persalinan. PRES adalah sindrom edema vasogenik dan kerusakan sawar darah otak, yang mempengaruhi struktur kortikal dan subkortikal dan semua daerah otak. Ada kecenderungan pada lobus parietal dan oksipital, kadang-kadang mengakibatkan gangguan penglihatan atau kebutaan kortikal. Hadir dengan keluhan sakit kepala thunderclap yang parah, RCVS menyebabkan vasospasme arteri sirkulus Willisi dan dapat dikaitkan dengan stroke iskemik dan subarachnoid hemorrhagic (SAH) nonaneurisma, biasanya di atas convexitas serebral.

Downloads

Download data is not yet available.

Author Biographies

Dewi Yulianti Bisri, Faculty of Medicine Universitas Padjadjaran Bandung

Department Anesthesiology and Intensive Care Dr. Hasan Sadikin General Hospital Bandung

Tatang Bisri, Faculty of Medicine Universitas Jend. Ahmad Yani Cimahi Bandung, Indonesia

Department of Anesthesiology and Intensive Care Melinda Hospital Bandung

References

Miller EC. Preeclampsia and cerebrovascular disease the maternal brain at risk. Hypertension. 2019;74(1):5–13. Doi: 10.1161/HYPERTENSIONAHA.118.11513

Dyer RA, Swanevelder JL, Bateman BT. Hypertensive disorders. In: CHESTNUT’S OBSTETRIC ANESTHESIA PRINCIPLES and PRACTICE, 6th ed, Elsevier 2020

Lim KH, Steinberg G, Ramus RM. Preeclampsia. Medscape. 2022. [Internet]. Tersedia dari: https://emedicine.medscape.com/article/1476919-overview?form=fpf

Bisson C, Dautel S, Patel E, Suresh S, Dauer P, and Rana S. Preeclampsia pathophysiology and adverse outcomes during pregnancy and postpartum. Front Med (Lausanne). 2023; 10: 1144170. Doi: 10.3389/fmed.2023.1144170

Lewis E, Davies S. Hypertensive disease. Dalam: Collis R, Harries S, Theron A, eds. Obstetric Anaesthesia, 2nd ed, Oxford University Press 2020

Chang KJ, Seow KM, Chen KH. Preeclampsia: recent advances in predicting, preventing, and imaging the maternal and fetal life-threatening condition. Int J Environ Res Public Health. 2023;20(4):2994. Doi: 10.3390/ijerph20042994

McConnell HL, Mishra A. Cell of the blood-brain barriere: an overview of neurovascular unit in health and disesase. Methods Mol Biol. 2022;2492:3-24. Doi: 10.1007/978-1-0716-2289-6_1

Tentulouis-Piperas V, Lymperopoulos L, Tountopoulou A, Vassilopoulou S, Mitsikostas DD. Headache atrribute to reversible cerebral vasocontriction syndrome (RCVS). Diasostic (Basel). 2023;13(17):2730. Doi: 10.3390/diagnostics13172730

Calic Z, Cappelen-Smith C, Zagami AS. Reversible cerebral vasoconstriction syndrome. Intern Med J. 2015;45:599–608. doi: 10.1111/imj.12669.

Soh Y, Yasuhi I, Nakayama D, Ishimaru T. A case of postpartum cerebellar infarction with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. Gyneco Obstet Invest. 2002;53(4):240–42. Doi: 10.1159/000064564

Altamura C, Vasapollo B, Tibuzzi F, Novelli GP, Valensise H, Rossini PM, et al. Postpartum cerebellar infarction and haemolysis, elevated liver enzymes, low platelet (HELLP) syndrome. Neurol Sci. 2005;26(1):40–42. Doi: 10.1007/s10072-005-0380-2

Porras JL, Yang W, Philadelphia E, Law J, Garzon-Muvdi T, Caplan JM, et al. Hemorrhage risk of brain arteriovenous malformations during pregnancy and puerperium in a north American cohort. Stroke. 2017;48(6):1507–1513. Doi: 10.1161/STROKEAHA.117.016828

Dias MS, Sekhar LN. Intracranial hemorrhage from aneurysms and arteriovenous malformations during pregnancy and the puerperium. Neurosurgery. 1990;27(6):855–65– discussion 865–6. Doi: 10.1097/00006123-199012000-00001

Liu X-J, Wang S, Zhao Y-L, Teo M, Guo P, Zhang D, et al. Risk of cerebral arteriovenous malformation rupture during pregnancy and puerperium. Neurology. 2014;82(20):1798–803. Doi: 10.1212/WNL.0000000000000436

Brenner B. Haemostatic changes in pregnancy. Thromb Res. 2004;114(5–6):409–14. Doi: 10.1016/j.thromres.2004.08.004

James AH, Bushnell CD, Jamison MG, Myers ER. Incidence and risk factors for stroke in pregnancy and the puerperium. Obstet Gynecol. 2005;106(3):509–516. Doi: 10.1097/01.AOG.0000172428.78411.b0

Wu P, Haththotuwa R, Kwok CS, Babu A, Kotronias RA, Rushton C, et al. Preeclampsia and future cardiovascular health: A systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2017;10(2):e003497. Doi: 10.1161/CIRCOUTCOMES.116.003497

CROSSMARK
Published
2024-03-21
DIMENSIONS
Section
Literature Review

Most read articles by the same author(s)

1 2 > >>