Pregnancy and Stroke

[Blessed]

I am a 38 year old female who suffered a mild stroke 3 weeks ago. I was approx 12 weeks pregnant at the time.  I have not used birth control pills for almost 10 years. The doctors say it was a blod clot in the thalmus (sp?) region.  My deficits are a blind spot in the left side of both eyes and a numb left arm.  The doctors cannot tell me what brought on the stroke, although they say the pregnancy may have caused a hypercoaguble state.  I do not have high blood pressure, chlosterol, or any of the typical risk factors. I have had severe migraines since I was 5. I had a dull headache (not a migraine)at the time of the stroke. I have had genetial herpes for the last 15 years.
My question is:  could the herpes have been related to the stroke?  I know there is some new research that chronic infections can lead to stroke.

Any thoughts you have on what caused the stroke would be appreciated.

[CCF Neuro[P]-M.D.-RPS]

Dear Blessed:

I am sorry that you have had a stroke.  Hos is the pregnancy?  I hope that it is still going well.  Pregnancy can cause a hypercoagulable state, and that can lead to stroke.  Although the thalamus is not the most common site, more so in hypertensive stroke.  Although you might not have hypertension, you might have had an episode that caused this stroke (unknown).  Did they say that your talamic stroke was hemorrhagic or ischemic?  Since you had a headache, I would think it would have been hemmorrhagic.  This would be another indication that you might have had a hypertensive spike that induced your stroke.  

I do not believe that your herpes had much to do with your stroke.  There are some types of Herpes viruses, such as vericella or chicken pox, that can induce a vasculitis and lead to stroke, you would have had an outbreak of your Herpes near the time of your stroke and therefore you would have known it.  

One needs to find out the etiology of the stroke and try to limit the factors inducing the stroke.  Pregnancy can induce a hypercoaguable state and therefore this should be fully worked up including the Leiden factor and thrombin gene.  I would make every effort in finding the reason and trying to allow the pregnancy to go well.  

Since the thalamic stroke was in your dominant thalamus (assuming that your right handed) you might have some problems which you should talk to your neurologist about.  There is sometimes unexplained pain with thalamic lesions, and some have problems with motivation and getting thing initiated.

I hope your are doing well.

Sincerely,

CCF Neuro MD

[BJP]

Did the doctor suggest that you be tested for Antiphospolipid or Anticardiolipin Antibodies..Or factor V Leiden...  You are so young with no known risk factors and it happened while pregnant..Thats why I ask..I have also heard about the Herpes link but I am not so sure about that. I have an friend who had this happen to her and it turned out to be Antiphospholipid Syndrome which puts her at risk for things like this so she is now on preventative medications....Take Care and I wish you the best with your pregnancy..and I hope that thats the last propblem you have...Take care

[Blessed]

I do not know if I was tested for either condition.  I have an appointment with my neurologist next week and I will certainly ask him.  Thank you for your input!

[E]

this happened to me as well...except they do not know for fact i had a stroke since nothing showed up on mri..i was 8 months pregnant and had left sided numbness....turns out 1 year later, i am finally being sent to a hemotologist because my antiphospholipid test came back borderline abnormal...have this test ran on you!  i think it is a lupus anticoagulant test.  im in the process of finding out what my treatment will me.  good luck!

[BJP]

As you can see Antiphospoholipid syndrome is not so rare and it can be the cause of your problem..So please mention this test to the doctor when you go in....Take care and I wish you the best in your pregnancy and with your health..Take care of yourself and Eat well and Take your Vitamins and watch your Blood Pressure and most of all try not to worry ....Best Wishes  Betty

[Blessed]

A follow-up question from Blessed:
Is there a link between ASP and a recurring infection, such as herpes?

[Fierh]

I have a cerebral vascular disease called Moyamoya.  Several people that I know (through NORD) of who have this disease also had strokes when they were pregnant.  Moyamoya is a very rare disease and it is also a life threatening disease.  Moyamoya usually happens to women in their early twenties but that doesn't mean you couldn't have it.  I was 29 when I was first diagnosed with it.  I wasn't pregnant but I was on birth control pills which are like a fake pregnancy.  PLEASE, PLEASE, PLEASE mention this disease to your neurolgist!!!  And look it up on the Internet!

[Blessed]

To CCF Neuro-M.D.-RPS:

Hi - unfortunately, the baby did not have a heartbeat when they checked 8 days after the stroke.  They performed a D+C.
I have a few follow-up questions for you:
Would a stressful month at work lead to hypertension?
You asked if my stroke was ischemic and it was.
I have HSV-8 and had an outbreak 2 weeks after the stroke.
Would Moya Moya have shown up on an MRI?
Also, could eating a lot of foods containing Vitamin K have triggered hypercoagulation?

Thank you for your help!

[BJP]

I am so sorry about your baby. I do hope that you do well in the future and remain Stroke free. you are so young and should not have to be dealing with this. I would love to know what they discover about the cause of your stroke and how things go for you in the future. Please if you would like write to me and keep me updated on how your doing..Your in my prayers and Best Wishes to you...Betty
***@****

[Fierh]

I had several tests before they diagnosed the moyamoya.  They did a MRI with dye that showed some abnormality in the brain.  Then I had an angiogram with dye and that showed the moyamoya.Your brain will make new blood vessels so the blood can get around. These new blood vessels are very tiny and they lool wispy, like smoke on the a-gram.  I had my brain surgery at UVA in Charlottesville, VA.  Feel free to ask more questions.  I will check this site as often as I can.  Also, I am sorry about the lost of your baby.

[pregnanttoo]

I'd just completed reading about BAM migrains and their potential to cause strokes when I came across your posting.  There are other migrains, in addition to BAM, that so constrict the blood vessels that oxygen is cut off to a section of the brain and stroke symptoms result.  The area of the brain affected depends on the type of migrain.  Due to the relationship between the migrain and onset of your stroke symptoms, you may not have to look for any other causes.  If I remember right the BAM induced stroke is ischemic.  There is info on the internet on this.  I'm very sorry to hear about your baby.

[BJP]

I would like to know more about Moya Moya..as well as BAM headaches...Many of my migraines present with eye disturbance and numbness and weakness and vauge weird feelings..I have been told occular Migraine, Migraine Variant etc..I woulld like to know what Moya Moya is and how it presents and what the prognosis is as well as about BAM headaches in relationship to strokes..Betty
My e-mail is ***@**** Thank You

[Fierh]

When I was first  diagnosed with Moyamoya I had sever(sp?) headaches and blurred vision.  Also, my right hand would turn and move and pull up by itself as would my right foot.  These were TIAs but I didn't know it at the time. I had about 6 episodes where the whole right side of my body would go numb and I was unable to talk and could barely walk or move. I'm not really sure if those would be classified as mini-strokes or just really bad TIAs.  The moyamoya was diagnosed when I  had an a-gram done. (Dye was injected into my head via the groin area.)  And the doctors were able to tell that my blood vessels were not the way they were supposed to be.
That's all I can think to tell you right now, but if you think of anything else, just ask

[irfan101054]

A related discussion, General was started.

[dani_elle]

A related discussion, Can anyone answer?? was started.