Chapter 31 Pregnancy and Disorders of the Nervous System

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Presentation transcript:

Chapter 31 Pregnancy and Disorders of the Nervous System Michael J. Aminoff Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 31-1 Percentages of pregnancy outcome in relationship to mean serum folate levels in the first trimester dichotomized as less than 4 (subnormal) or at least 4 ng/ml. N=number of pregnancies with subnormal or normal serum folate levels. A significantly higher number of pregnancies with subnormal levels resulted in an abnormal outcome than did pregnancies with normal levels. Using Fisher’s exact test, P=0.05 for spontaneous abortion and P=0.03 for total abnormal outcomes. (From Dansky LV, Andermann E, Rosenblatt D, et al: Anticonvulsants, folate levels, and pregnancy outcome: a prospective study. Ann Neurol 21:176, 1987, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 31-2 Thrombosis of the left transverse sinus. A, Axial postcontrast T1-weighted MR image shows a filling defect within the left transverse sinus consistent with thrombosis (arrowheads). B, Coronal MR venogram confirms thrombosis of the left transverse sinus (arrows). (Courtesy of William P. Dillon, MD, University of California, San Francisco.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 31-3 Axial T2-weighted MR scan showing a large mass of flow voids involving the thalamus, typical of an arteriovenous malformation. The large flow voids (arrows) are venous varices, indicating possible outflow obstruction and increased risk of hemorrhage. Midline shift of the lateral ventricle is evident. (Courtesy of William P. Dillon, MD, University of California, San Francisco.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 31-4 Sagittal T2-weighted MR scan of the thoracic spine illustrates edema of the central spinal cord (arrowheads) and enlarged flow voids posteriorly (arrows). The findings are typical of a spinal dural arteriovenous fistula. (Courtesy of William P. Dillon, MD, University of California, San Francisco.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 31-5 Posterior reversible leukoencephalopathy syndrome (PRES) in a patient with eclampsia, following a seizure. Axial T2-weighted FLAIR MR image demonstrates symmetric high signal intensity, in this instance involving also the cortex of the frontal and parietal lobes bilaterally. (Courtesy of William P. Dillon, MD, University of California, San Francisco.) Copyright © 2014 Elsevier Inc. All rights reserved.