Postpartum Cervical Manipulation, Vertebral Artery Dissection and Reversible Cerebral Vasoconstriction: A Case Report

Abstract

Stroke in the postpartum population is rare, but more common than non-pregnant states. Pathophysiology is more evenly split between hemorrhagic and ischemic etiologies and antecedent severe hypertensive disorders such as pre-eclampsia predominate. We describe a case of both potential minimally traumatic significant vertebral arterial dissection, posterior circulation ischemic stroke with lateral medullary syndrome and concomitant incidental reversible cerebral vasoconstriction on neuroimaging initially referred to the obstetric team as late postpartum pre-eclampsia and discuss diagnostic and management challenges. J Clin Gynecol Obstet. 2019;8(3):97-102 doi: https://doi.org/10.14740/jcgo576