Neuroimaging

Pregnancy-related changes may influence preexisting medical conditions or bring previously unknown neurologic conditions to clinical attention. This chapter reviews the physiologic changes most germane to the imaging of neurologic conditions, safety issues related to diagnostic imaging during pregnancy, and the imaging findings of a spectrum of neurologic conditions with common clinical presentations. During pregnancy, consistently elevated estrogen levels are also associated with improvement in certain migraine headaches, with 11%, 53%, and 79% of women reporting improvement in headaches symptoms during first, second, and third trimesters. Rarely, conditions such as eclampsia and the related posterior reversible encephalopathy syndrome (PRES), also known as reversible posterior leukoencephalopathy syndrome (RPLS), as well as postpartum cerebral angiopathy (PCA) may present with intracranial hemorrhage. A patient with preeclampsia presenting with seizures is diagnosed with eclampsia and aggressive medical management is required to prevent manifestations of hypertensive encephalopathy and PRES/PRLS.