RESUMO
This case report alerts the psychiatric clinician to consider nonpsychiatric etiologies of psychosis appearing during the postpartum period besides postpartum psychosis. The case includes a description of the patient's psychiatric presentation, admission to the inpatient psychiatric unit with subsequent transfer to the medicine department including neuroimaging and neurological consultation. The patient had a remission of psychosis after only two and half days of antipsychotic medication administration. Positive findings on the MRI suggested a demyelinating disease and a 4-month follow up MRI continued to be positive. The etiology was presumed to be a demyelinating disease. In conclusion, psychiatrists need to be alert to include nonpsychiatric pathologies in the differential diagnosis when a patient presents with psychosis in the postpartum period.
Assuntos
Doenças Desmielinizantes/diagnóstico , Período Pós-Parto , Transtornos Psicóticos/diagnóstico , Adulto , Doenças Desmielinizantes/diagnóstico por imagem , Diagnóstico Diferencial , Erros de Diagnóstico , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Transtornos Psicóticos/diagnóstico por imagem , Transtornos Psicóticos/etiologia , RadiografiaAssuntos
Lúpus Eritematoso Sistêmico/complicações , Síndrome da Leucoencefalopatia Posterior/etiologia , Adolescente , Encéfalo/patologia , Diagnóstico Diferencial , Feminino , Febre/etiologia , Cefaleia/etiologia , Humanos , Lúpus Eritematoso Sistêmico/patologia , Lúpus Eritematoso Sistêmico/terapia , Vasculite Associada ao Lúpus do Sistema Nervoso Central/complicações , Vasculite Associada ao Lúpus do Sistema Nervoso Central/patologia , Imageamento por Ressonância Magnética , Síndrome da Leucoencefalopatia Posterior/patologia , Síndrome da Leucoencefalopatia Posterior/terapia , Convulsões/etiologia , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Placental chorioangiomas are benign vascular tumors. Large chorioangiomas cause several obstetric complications, including premature labor, placental abruption, polyhydramnios, fetal hydrops, fetal growth restriction, fetal hepatosplenomegaly, cardiomegaly, congestive heart failure, and fetal death. The neonatal complications are hydrops fetalis, microangiopathic hemolytic anemia, and thrombocytopenia. The cause of perinatal cerebral arterial infarction remains unclear in the majority of cases. Investigators have reported a number of obstetric and neonatal complications in the setting of perinatal stroke, including birth asphyxia, preeclampsia, chorioamnionitis, cardiac anomalies, polycythemia, systemic infection, and genetic thrombophilias. We present a rare case of perinatal cerebral infarction associated with placental chorioangioma.
