Neurological Disorders Associated with Pregnancy: A Hospital Based Imaging Study of 57 Cases in North-East India.

ABSTRACT

Aims: To evaluate and characterize the Computed Tomography and Magnetic Resonance Imaging findings of the various neurological conditions of the central nervous system and pituitary gland that can occur during pregnancy and post partum period. Place and Duration of Study The study was carried out in the Department of Radiology, Gauhati Medical College and Hospital, Guwahati, from August 2012 to July 2013. Methodology: A total of 57 patients of neurological disorders of the central nervous system and pituitary gland associated with pregnancy, who were referred to the Department for radiological evaluation and who had positive imaging findings were taken up for the study. CT scan was performed in those cases referred for imaging. For further evaluation, cases were referred to MRI or wherever possible, cases were directly referred for MRI. Contrast CT was avoided in most of the cases. Results: Out of 57 patients, 54.39% patients were in age between 20 to 30 years. Headache was the most common presenting complaint (71.93%) in all the neurological disorders. Hypertensive encephalopathy (40.35%) was the most common neurological disorder followed by Cerebral Venous Thrombosis (17.54%). Infarct was the commoner complication of hypertensive encephalopathy accounting for 21.74% of cases. Magnetic resonance was able to detect infarct in 21.74% of cases compared to CT which could detect infarct in 13.04% of cases. P value 0.3534 and sensitivity 72%, 95% Confidence Interval 0.46 to 0.90 with negative predictive value 50% with 95% Confidence Interval 0.18 to 0.81. Conclusion: Both CT and MRI can depict the characteristic imaging features of these neurological disorders in pregnancy as well as development of complications, hence leading to early and prompt diagnosis of these disorders and better management of these patients. ABBREVIATIONS CI Confidence Interval, TOF MRA Time of Flight Magnetic Resonance Agiography, MRV Magnetic Resonance Venography, TR repetation time, TE echo time, FLAIR Fluid Attenuated Inversion Recovery, DWI diffusion weighted image, SWI Susceptibility Weighted Imaging, NECT non enhanced computed tomography, ESR erythrocyte sedimentation rate, ADC Apparent diffusion coefficient.