Imaging Neurologic Conditions in Pregnant Patients

Executive Summary:

  • Neurological symptoms may be exacerbations of existing problems (MS, seizure); initial manifestation of neurological disorder (tumor, stroke) or issue unique to pregnancy (eclampsia, postpartum cerebral angiopathy, Sheehan syndrome and lymphocytic adenohypophysitis.
  • ACR Guidance on safe MRI practices states pregnant patients should undergo MRI only if the information cannot be obtained any other way.
  • Autoimmune hypophysitis is a rare chronic inflammatory disorder of the pituitary stalk and gland.  It is classified by involved portions of the gland.
  • Spontaneous or postinstrumentation intracranial hypotension.
  • Source Paper

Iodinated CT contrast and Gadolinium contrast agents are acceptable to use, so long as the diagnostic benefit outweighs the risk.  CT contrast is category B and Gad is Category C.  Usual principles of limiting imaging apply.

More Common and Less Common Neurologic Conditions in Pregnant Patients

More common conditions

Epilepsy and seizure
Infarct- or hemorrhage-related stroke
Venous thrombosis
Pituitary disorders

Less common conditions

Metastasis from choriocarcinoma
Meningioma and glioma
Vasoconstriction syndrome
AVM rupture
Movement disorders
Multiple sclerosis
Wernicke encephalopathy
Bell palsy
Intracranial hypotension


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