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Ginecología y obstetricia de México

Print version ISSN 0300-9041

Abstract

SERRANO-BERRONES, Miguel Ángel  and  CENTENO-DURAN, Georgina. Reversible cerebral vasoconstriction syndrome (Call-Fleming) during puerperium: A case report. Ginecol. obstet. Méx. [online]. 2019, vol.87, n.3, pp.213-216.  Epub Apr 30, 2021. ISSN 0300-9041.  https://doi.org/10.24245/gom.v87i3.2199.

BACKGROUND:

Reversible cerebral vasoconstriction syndrome, or Call-Fleming syndrome, is an exceptional disorder of uncertain origin, characterized by headache, neurological deficit and reversible cerebral vasospasm. Regarding its physiopathological mechanism, the relationship with reversible segmental vasoconstriction in different brain areas has been postulated.

CLINICAL CASE:

A 34-year-old patient, in the 40 weeks pregnant, admitted to the medical unit due to irregular uterine activity, with blood pressure figures of 120/80 mmHg, pulse 80/min, respiratory rate 20/min and temperature of 37 ° C; the fetal heart rate was 140 beats per minute. Due to the non-progression of labor, it was decided to interrupt it by abdominal route, from which a healthy newborn was obtained. During the immediate puerperium, after the administration of ergonovine, the patient manifested arterial hypertension and sudden headache related to neurological deficit, for which she required admission to the Intensive Care Unit until stabilization. The diagnosis of "thunder" type headache was established; the computed tomography showed no apparent alterations, the cerebrospinal fluid was clear, and leukocyte concentration of 10 mm3 and erythrocyte of 6 mm3.

CONCLUSION:

Call-Fleming syndrome is a rare condition during pregnancy and puerperium; therefore, it is important to know, identify and establish the differential diagnosis of the disease.

Keywords : Reversible cerebral vasoconstriction syndrome; Call-Fleming syndrome; Pregnancy; Puerperium; Ergonovine.

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