目的：探讨妊娠与产褥期并发脑血管疾病患者的发病时间、病因、危险因素、临床表现及预后。

方法：对2013 年1 月—2017 年5 月上海交通大学医学院附属仁济医院收治的20 例妊娠与产褥期并发脑血管疾病患者的临床资料进行回顾性分析。

结果：在20 例妊娠与产褥期并发脑血管疾病的患者中，12 例发生脑出血，病因包括脑血管畸形、静脉窦血栓形成、红斑狼疮并发症、垂体瘤鞍内出血、听神经瘤、海绵状血管瘤、烟雾病等；2 例发生蛛网膜下腔出血，病因均为颅内动脉瘤破裂；6 例发生脑梗死，病因包括房颤（风湿性心脏病导致）致脑栓塞、抗心磷脂抗体综合征、静脉窦血栓形成等。20 例患者中，18 例存活，2 例死亡。8 例患者顺利分娩出胎儿，但其中1 例患者死亡，另7 例患者恢复良好。

结论：妊娠与脑血管疾病危险因素之间的相互作用可增加脑血管疾病发生风险，尤其是妊娠后期脑出血风险增加。当孕产妇出现急性/ 亚急性头痛、呕吐、意识障碍、肢体无力及其他神经系统局灶性体征时，应警惕脑血管疾病的发生；影像学检查能够及时明确诊断并发现病因；及时的多学科联合治疗有助于改善预后。

Objective: To investigate the time of onset, etiology, related risk factors, clinical manifestations and prognosis of cerebrovascular diseases during pregnancy and puerperium.

Methods: Retrospective analysis of the clinical data of 20 patients with cerebrovascular diseases during pregnancy and puerperium, who were admitted in Renji Hospital, Shanghai Jiao Tong University School of Medicine between January 2013 and May 2017, was conducted.

Results: Of the 20 patients with cerebrovascular diseases during pregnancy and puerperium, 12 patients developed cerebral hemorrhage due to cerebral vascular malformation, venous sinus thrombosis, lupus erythematosus complication, hemorrhage of pituitary tumor, acoustic neuroma, cavernous hemangioma and Moyamoya disease; 2 patients developed subarachnoid hemorrhage due to aneurysm rupture; 6 patients developed cerebral infarction due to cerebral embolism caused by atrial fibrillation (rheumatic heart disease), anti-cardiolipin antibody syndrome and venous sinus thrombosis formation. Of 20 patients, 18 survived, and 2 died; 8 patients successfully delivered the fetus, but 1 patient died and the other 7 patients recovered well.

Conclusion: The risk factors of pregnancy and the cerebrovascular diseases interact to increase the risk of cerebrovascular diseases, especially the risk of cerebral hemorrhage is increased during late pregnancy. When pregnant women present with acute/subacute headache, vomiting, disturbance of consciousness, weakness of the limbs, and other nervous system focal signs, they must be alert to the occurrence of cerebrovascular diseases. Imaging examinations can promptly confirm the diagnosis and find the cause. Timely multidisciplinary combination therapy can help improve the prognosis.