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Case report
Ischaemic stroke and pre-eclampsia in the third trimester of pregnancy: a diagnostic and therapeutic challenge
  1. Alexandros Loukas Grammatis1,
  2. Hannah Louise Catton2 and
  3. Derek Hilton3
  1. 1Obstetrics and Gynaecology, Buckinghamshire Healthcare NHS Trust, Ayelsbury, UK
  2. 2Anesthetics, Buckinghamshire Healthcare NHS Trust, Ayelsbury, UK
  3. 3Neurology, Wexham Park Hospital, Wexham, UK
  1. Correspondence to Alexandros Loukas Grammatis; alexgrammatis{at}


A 23-year-old low-risk primiparous patient, who was 35 weeks pregnant, presented in the emergency department after collapsing at home. Her observations showed severe hypertension with proteinuria. On examination, she had left hemiparesis and was aphasic. Fetal monitoring was reassuring. Initial CT did not reveal any evidence of intracranial pathology. She was stabilised and delivered via emergency caesarean section. Subsequent MRI and CT showed an acute right-sided infarct involving the right middle cerebral artery territory, frontal and parietal regions, and increased mass effect. She was transferred to the nearest neurosurgical centre where she was conservatively managed and discharged home 3 weeks later for continuing rehabilitation. She achieved a good recovery.

  • obstetrics and gynaecology
  • stroke
  • pregnancy
  • hypertension
  • anaesthesia

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  • Contributors The report was written solely by ALG and HLC. Edited and supervised by DH.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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