International Stroke Conference Digest - February 20, 2008 - (Page 4)

2008 isc digest | New Orleans | februAry 20 4 Relationship between stroke, pregnancy, and ovarian hormones to be discussed PRegnancy and the use of oral contraceptives and hormone replacement therapy are known stroke risk factors, and stroke is a major contributor to serious morbidity and mortality during pregnancy. To help attendees better understand the relationship between stroke, pregnancy, a nd ova r ia n hor mones, a spec ia l symposium will be held today titled “Ovarian Hormones, Pregnancy and Stroke: Risks, Management and Prevention.” The symposium will meet from 2:00 to 3:30 p.m. in La Louisiane C. “This seminar will update attendees on aspects of cerebrovascular disease as it relates to pregnancy and ovarian hormones. Speakers will discuss management options for clinicians,” said session co-moderator Barney J. Stern, MD, Professor of Neurology and Director of the Clinical Stroke Program at the University of Maryland, Baltimore. “The implications to neurologists of treating pregnant women is that suddenly you are treating two patients rather than one, and clinicians must consider the health of both the mother and the fetus,” Dr. Stern continued. “Often, when problems arise, they arise acutely, and so we are trying to bring the audience up to date on current management concepts and key issues related to decision making.” Issues relating to birth control pills and hormone replacement therapy as potential stroke risk factors center on their impact on the vasculature and brain, Dr. Stern added. “Women who have migraine with aura and who are hypertensive or smoking are thought to be at considerably increased risk of stroke, especially when taking oral contraceptives,” he said. “The issue of postmenopausal hormone replacement therapy has been analyzed in several studies and linked to stroke risk.” The management issues that need to be considered in regard to ischemic stroke include options for primary or secondary stroke prevention in high-risk patients, including patients with known cardiac disease. Other patients have vascular anomalies, such as aneurysms or ar teriovenous malformations that predispose to hemorrhagic stroke, Dr. Stern said. “ The issues related to t reat ment include the use of thrombolytic therapy in the setting of acute ischemic stroke in a pregnant woman and the management of vascular anomalies during pregnancy,” he added. The session’s other co-moderator, Di lip K. Pandey, M D, Ph D, Associate Professor of Neurology and Director of Neuroepidemiology and Clinical Trials at the University of Illinois College of Medicine at Chicago, said the symposium will also focus on the translational aspects of research into the relationship between endogenous ovarian hormones, hormonal therapy, and the risk of stroke and its management. “There’s lots of confusion in this field at this time,” he said. While the Women’s Health Initiative study has shown that hormone replacement therapy increases the risk of stroke, “studies in animal models have shown a neuroprotective effect. The presenters for this seminar will offer attendees clear direction,” Dr. Pandey said. “This session will be very informative for attendees,” he added. “It will present current knowledge gained from animal models and epidemiologic studies and compare that information to the results of clinical trials. When we look at animal studies, we need to look critically at how the results can be translated safely to clinical care.” Dr. Stern added: “This topic is always an x iet y-provoking to patients, their families, and physicians engaged in the care of women at various stages in their life. The issue of hormone use continues to be explored as it relates both to stroke risk and stroke therapy.”

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International Stroke Conference Digest - February 20, 2008

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