When Mother and Fetus Face Neurological Emergencies: A Case of Pregnancy-Associated Stroke

Background: Stroke is a neurological emergency characterized by acute focal injury to the central nervous system caused by vascular events. Although rare, pregnancy-associated stroke represents a major cause of maternal morbidity and mortality, with an incidence of approximately 30–34 per 100,000 pregnancies. Hypertensive disorders and the hypercoagulable state of pregnancy are leading risk factors. Case Report: We present the case of a 26-year-old gravida 3 para 1 woman at 26 weeks and 5 days of gestation with a history of chronic hypertension, who was admitted with sudden-onset left-sided weakness and facial asymmetry. Neuroimaging revealed acute ischemic lesions in the right lentiform nucleus, parietal and parieto-occipital lobes, and a thrombus in the inferior cerebral vein. The patient was managed in the intensive care unit with therapeutic anticoagulation (enoxaparin) and close maternal-fetal monitoring. Fetal viability and well-being were preserved, and corticosteroids were administered for lung maturation. Multidisciplinary follow-up ensured stabilization, and the patient was discharged in good condition with recommendations for continued neurological and obstetric care. Conclusion: Pregnancy-associated stroke is a rare but potentially life-threatening condition that requires prompt recognition, rapid neuroimaging, and a multidisciplinary approach to optimize maternal and fetal outcomes. This case highlights the importance of timely intervention and coordinated care in managing neurological emergencies during pregnancy.