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Preeclampsia and Cerebrovascular Disease.

Preeclampsia, a hypertensive disease affecting 5% to 8% of pregnancies, is a multisystem disorder, with vascular dysfunction being central to the disease. The heterogeneity of preeclampsia’s signs and symptoms has generated controversy regarding whether the cause of preeclampsia is mainly related to maternal or placental factors (Tables S1 and S2 in the online-only Data Supplement). Most researchers agree that placental hypoxia and oxidative stress play an important role in the pathophysiology of preeclampsia, leading to a cascade of downstream effects. The maternal cerebral vasculature is highly vulnerable to adverse effects of preeclampsia. Shortand long-term cerebrovascular complications of preeclampsia include posterior reversible encephalopathy syndrome (PRES), reversible cerebral vasoconstriction syndrome (RCVS), hemorrhagic and ischemic stroke, cerebral small vessel disease, and vascular dementia. This review summarizes current evidence and recent advances in our understanding of the effects of preeclampsia on cerebrovascular disease in women and outlines gaps in knowledge and directions for future research.