Cerebrovascular pathophysiology in preeclampsia and eclampsia

Marilyn J. Cipolla, Gerda G. Zeeman, F. Gary Cunningham

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations

Abstract

The brain plays a pivotal role in the preeclampsia syndrome. Recent progress has been made in understanding the causes and consequences of its cerebrovascular complications. Non-invasive techniques such as transcranial Doppler (TCD) and high-resolution magnetic resonance imaging (MRI) have made it possible to study adaptations in the brain to pregnancy and preeclampsia. Animal studies highlight several underlying mechanisms by which pregnancy and experimental preeclampsia influence cerebrovascular structure and function. Some clinical and pathological as well as neuroimaging features of eclampsia are an expression of the posterior reversible encephalopathy syndrome (PRES). Its pathophysiology is a matter of debate and, recently, its reversibility has been questioned. Current emphasis includes failure of the autoregulatory capacity and breakdown of the blood-brain barrier in the presence of endothelial dysfunction. All eclampsia can no longer be conceptualized as a transient and fully reversible event and it may have serious life-long consequences. This concept bears important implications for current pathophysiologic, preventive, and therapeutic concepts of eclampsia.

Original languageEnglish (US)
Title of host publicationChesley's Hypertensive Disorders in Pregnancy, Fourth Edition
PublisherElsevier Science
Pages269-290
Number of pages22
ISBN (Electronic)9780124078666
DOIs
StatePublished - Jan 1 2014

Keywords

  • Cerebral edema
  • Cerebral hemodynamics
  • Eclampsia
  • Posterior reversible encephalopathy syndrome

ASJC Scopus subject areas

  • Medicine(all)

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    Cipolla, M. J., Zeeman, G. G., & Gary Cunningham, F. (2014). Cerebrovascular pathophysiology in preeclampsia and eclampsia. In Chesley's Hypertensive Disorders in Pregnancy, Fourth Edition (pp. 269-290). Elsevier Science. https://doi.org/10.1016/B978-0-12-407866-6.00013-4