Neurological complaints and brain MRI findings in pregnant and postpartum patients: experience from an academic tertiary referral center

Abstract Background Neurological complaints are common in pregnancy due to physiological, hormonal, immunological, and hemodynamic changes. Differentiating pathological from pregnancy-related issues is crucial. This study aims to determine the frequency and spectrum of brain MRI abnormalities linked to acute neurological signs in high-risk pregnant and postpartum patients. Methods This was a retrospective study conducted at Namazi and Faghihi Hospitals of Shiraz University of Medical Sciences. We evaluated 139 hospitalized pregnant or postpartum patients (up to 42 days post-delivery). Data collected included age, sex, past medical history, MRI findings, and clinical neurological complaints. The primary analysis focused on describing the frequency of neurological signs/symptoms and brain MRI findings. Inferential statistics (Pearson Chi-Square and Fisher’s exact tests) were used to assess the association between demographic features, specific clinical complaints, and abnormal MRI findings. Results A total of 139 patients participated in our study. The frequency of neurological signs and symptoms observed was as follows: headache in 96 patients (69%), convulsions in 28 patients (20%), unilateral neurological weakness in 17 patients (12.2%), blurred vision in 17 patients (12.2%), decreased level of consciousness in 12 patients (8.6%), dizziness and vertigo in 11 patients (7.9%), nausea and vomiting in 11 patients (7.9%), and slurred speech in 4 patients (2.9%). Out of the participants, 68 patients (48.9%) had normal brain MRI results. Among those with abnormal brain MRI findings, the results were as follows: nonspecific MRI findings in 21 patients (15.1%), Cerebral Venous Sinus Thrombosis (CSVT) in 12 patients (8.6%), cerebrovascular accidents (CVA) in 11 patients (8%), extra-axial hemorrhage in 6 patients (4.3%), intra-parenchymal hemorrhage in 6 patients (4.3%), posterior reversible encephalopathy syndrome (PRES) in 6 patients (4.3%), and intracranial hypotension in 4 patients (2.9%). Conclusion The most frequently observed pathological findings include CSVT and CVA. There was a significant link between unilateral neurological weakness and severe vascular events, such as CVA, CSVT, and intra-parenchymal hemorrhage. This highlights the importance of utilizing MRI to quickly distinguish between benign conditions and life-threatening central nervous system pathologies.