Cerebrovascular events are relatively rare in young patients. They may be seen in some patients at a younger age if there is history of predisposing medical conditions like sickle cell disease, protein c, protein s or antithrombin deficiency. The incident of stroke in non-pregnant females of reproductive age group is reported to be around 10 per 100000 women-years. There is 3 fold rise in the risk of cerebrovascular accidents in pregnant women of same age group. The common causes of such events in young women include, oral contraceptive pills use, Systemic lupus erythromatosus (SLE), antiphospholipid antibody syndrome (APLAS), reversible cerebral vasoconstriction syndrome (RCVS), vasculitis syndromes like takayasu’s arteritis, moyamoya disease and susac’s syndrome. Adverse cerebrovascular events are more common in pregnancy, postpartum and puerperal period as compared to non-pregnant women of same age. The predisposing factors for postpartum acute cerebrovascular disease include pre-eclampsia, eclampsia, pre-existing chronic kidney disease, diabetes mellitus, congenital or acquired hypercolagulable states and puerperal sepsis. Some of the common cerebrovascular events seen in postpartum period include cerebral venous thrombosis, reversible cerebral vasoconstriction syndrome, posterior reversible encephalopathy syndrome and postpartum angiopathy. The diagnosis of these conditions is usually by neuroimaging. This paper is a pictorial essay on the neuroimaging of some of the common cerebrovascular events seen in postpartum period. Familiarity with these neuroimaging findings is important to differentiate these conditions from other causes of altered sensorium in postpartum period like postpartum psychoses, electrolyte imbalance and eclampsia.

Keywords: Postpartum encephalopathy, stroke, Magnetic resonance imaging, MR Angiography.