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Adnan I. Qureshi, MD; Michael R. Frankel, MD; Jeffrey R. Ottenlips, VT; Barney J. Stern, MD

Arch Neurol. 1996;53(12):1226-1231.

Abstract
Objective
To test further the hypothesis that preeclampsia and eclampsia are associated with cerebral vasospasm.

Design
Prospective case study.

Setting
Inpatient obstetrics service of an urban public hospital.

Patients and Methods
Eleven women with eclampsia (mean gestational age, 32 weeks), preeclampsia (meangestational age, 36 weeds), or normotensive pregnancy (mean gestational age, 35 weeks). Middle cerebral artery (MCA) velocity was measured bilaterally in all patients by means of transcranial Doppler ultrasonography.

Results
Eclamptic patients (n=3) had significantly higher mean flow velocities and lower average pulsatility indexes than did normotensive patients (n=4) (average MCA-mean flow velocity, 165 vs 79 cm/s [P=.007]; average MCA pulsatility index, 0.51 vs 1.1 [P<.001]). Compared with normotensive pregnant women, preeclamptic patients (n=4) had lower average pulsatility indexes (0.76, P=.003), but similar mean flow velocities (average MCA—mean flow velocity, 82 cm/s; P=.8).

Conclusion
Significantly higher MCA velocities in eclamptic, but not preeclamptic, women compared with those in normotensive pregnant women suggests that moderate to severe vasospasm is associated with eclampsia.

Author Affiliations
From the Department of Neurology, Emory University School of Medicine, Atlanta, Ga.

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